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NPI 1164056255

NPI 1164056255 : JSN EYECARE : UVALDE, TX

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General NPI Number Information
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    NPI Number           |    1164056255
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    Entity Type          |    Organization 
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    Legal Business Name  |    JSN EYECARE 
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Dates
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    Enumeration Date     |    02/27/2020
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    Last Update Date     |    03/20/2020
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Provider Practice Location Address
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    Address Line         |    2112 E MAIN ST 
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    City                 |    UVALDE
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    State                |    TX
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    Zip                  |    78801-4850
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    Country              |    US
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    Telephone            |    830-278-2565
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2112 E MAIN ST 
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    City                 |    UVALDE
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    State                |    TX
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    Zip                  |    78801-4850
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    Country              |    US
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    Telephone            |    830-278-2565
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |    DR. ANJLI  PATEL 
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    Credential           |    OD
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    Telephone            |    806-316-9894
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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       |    
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    License Number State |    
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