Healthcare Provider Details

I. General information

NPI: 1932315116
Provider Name (Legal Business Name): RGV OPTICAL IMAGES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 07/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E NOLANA ST SUITE 6
MCALLEN TX
78504-6104
US

IV. Provider business mailing address

6701 N 25TH ST
MCALLEN TX
78504-4255
US

V. Phone/Fax

Practice location:
  • Phone: 956-423-2100
  • Fax:
Mailing address:
  • Phone: 956-423-2100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number StateTX

VIII. Authorized Official

Name: DR. VICTOR HUGO GONZALEZ
Title or Position: PRESIDENT
Credential:
Phone: 956-423-2100