Healthcare Provider Details

I. General information

NPI: 1356396386
Provider Name (Legal Business Name): FIONA KOLIA O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 N 10TH ST
MCALLEN TX
78504-7709
US

IV. Provider business mailing address

7400 N 10TH ST
MCALLEN TX
78504-7707
US

V. Phone/Fax

Practice location:
  • Phone: 956-682-1655
  • Fax: 956-682-1644
Mailing address:
  • Phone: 956-682-1655
  • Fax: 956-682-1644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number4589T
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: