Healthcare Provider Details

I. General information

NPI: 1508668443
Provider Name (Legal Business Name): RGV OPTICAL IMAGES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 11/06/2025
Certification Date: 11/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14855 BLANCO RD STE 210
SAN ANTONIO TX
78216-7729
US

IV. Provider business mailing address

PO BOX 4830
EDINBURG TX
78540-4830
US

V. Phone/Fax

Practice location:
  • Phone: 956-423-2800
  • Fax: 956-423-2888
Mailing address:
  • Phone: 956-423-2800
  • Fax: 956-423-2888

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: CARMEN ESCOBEDO
Title or Position: OPTICAL DIRECTOR
Credential:
Phone: 956-423-2800