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General NPI Number Information
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NPI Number | 1104335801
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Entity Type | Individual
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Provider Name | AMIRA YAMAMOTO OD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2017
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 6301 NW LOOP 410
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City | SAN ANTONIO
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State | TX
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Zip | 78238-3852
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Country | US
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Telephone | 210-866-7555
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Fax | 210-866-7565
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Provider Business Mailing Address
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Address Line | 659 CRESTWAY RD
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City | WINDCREST
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State | TX
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Zip | 78239-2116
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Country | US
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Telephone |
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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 | 27OA00676400
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9835T
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License Number State | TX
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