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General NPI Number Information
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NPI Number | 1023534922
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Entity Type | Individual
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Provider Name | MICHAEL PHILIP CEREAN OD
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Gender | Male
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Dates
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Enumeration Date | 08/22/2017
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 3331 WURZBACH RD
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City | SAN ANTONIO
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State | TX
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Zip | 78238-4042
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Country | US
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Telephone | 210-647-3333
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Fax | 210-680-5965
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Provider Business Mailing Address
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Address Line | 24307 HAELI PARK
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City | SAN ANTONIO
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State | TX
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Zip | 78255-2281
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Country | US
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Telephone | 832-527-4179
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9202T
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License Number State | TX
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