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General NPI Number Information
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NPI Number | 1124195342
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO RETINA ASSOCIATES, PLLC
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Dates
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Enumeration Date | 11/30/2006
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Last Update Date | 05/13/2011
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Provider Practice Location Address
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Address Line | 7940 FLOYD CURL #820
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3906
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Country | US
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Telephone | 210-615-8413
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Fax | 210-615-8417
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Provider Business Mailing Address
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Address Line | 7940 FLOYD CURL #820
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3906
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Country | US
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Telephone | 210-615-8413
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Fax | 210-615-8417
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | JAMES CHRISTOPHER MACDONALD
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Credential | M.D.
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Telephone | 210-615-8413
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | L1120
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License Number State | TX
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