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General NPI Number Information
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NPI Number | 1225024441
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Entity Type | Organization
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Legal Business Name | EYE CLINICS OF SOUTH TEXAS P.A.
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 09/27/2007
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Provider Practice Location Address
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Address Line | 999 E BASSE RD SUITE 128-B
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1801
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Country | US
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Telephone | 210-826-2012
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Fax | 210-829-8349
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Provider Business Mailing Address
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Address Line | 999 E BASSE RD SUITE 128-B
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City | SAN ANTONIO
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State | TX
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Zip | 78209-1801
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Country | US
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Telephone | 210-826-2012
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Fax | 210-829-8349
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAY RUBIN
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Credential | M.D.
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Telephone | 210-826-2012
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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 |
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License Number State |
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