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General NPI Number Information
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NPI Number | 1194018150
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Entity Type | Organization
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Legal Business Name | MAREDIA FAMILY EYECARE, PLLC
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Dates
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Enumeration Date | 05/24/2011
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Last Update Date | 09/11/2018
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Provider Practice Location Address
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Address Line | 1603 VANCE JACKSON RD
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City | SAN ANTONIO
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State | TX
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Zip | 78213-4470
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Country | US
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Telephone | 210-732-3200
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Fax | 210-731-9089
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Provider Business Mailing Address
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Address Line | 1603 VANCE JACKSON RD
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City | SAN ANTONIO
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State | TX
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Zip | 78213-4470
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Country | US
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Telephone | 210-732-3200
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Fax | 210-731-9089
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Authorized Official
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Title or Position | THERAPEUTIC OPTOMETRIST
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Name | DR. NAZIA N MAREDIA
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Credential | O.D.
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Telephone | 281-773-7262
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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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