Healthcare Provider Details
I. General information
NPI: 1962615195
Provider Name (Legal Business Name): NANCY EL-HITAMY AMIR,
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/07/2007
Last Update Date: 04/14/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9577 HUEBNER RD BLDG 4
SAN ANTONIO TX
78240-1687
US
IV. Provider business mailing address
9577 HUEBNER RD BLDG 4
SAN ANTONIO TX
78240-1687
US
V. Phone/Fax
- Phone: 210-228-0030
- Fax: 210-228-0277
- Phone: 210-228-0030
- Fax: 210-228-0277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 152WL0500X |
| Taxonomy | Low Vision Rehabilitation Optometrist |
| License Number | 05239TG |
| License Number State | TX |
VIII. Authorized Official
Name: DR.
NANCY
E
AMIR
Title or Position: OWNER
Credential: O.D.
Phone: 210-228-0030