Healthcare Provider Details

I. General information

NPI: 1275013393
Provider Name (Legal Business Name): E & S MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2018
Last Update Date: 04/19/2021
Certification Date: 04/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3166 SE MILITARY DR STE B105
SAN ANTONIO TX
78223-3978
US

IV. Provider business mailing address

3008 DAWN DR STE 105
GEORGETOWN TX
78628-2822
US

V. Phone/Fax

Practice location:
  • Phone: 210-774-5398
  • Fax: 561-828-8367
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DANIEL GARZA
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 561-275-2020