Healthcare Provider Details

I. General information

NPI: 1154284610
Provider Name (Legal Business Name): 211 EYE CARE PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15489 CULEBRA RD STE 307
SAN ANTONIO TX
78253
US

IV. Provider business mailing address

14244 POTRANCO RD STE 450
SAN ANTONIO TX
78253-2145
US

V. Phone/Fax

Practice location:
  • Phone: 210-701-8303
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: PETER NGUYEN
Title or Position: OWNER
Credential: O.D.
Phone: 832-640-9780