=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285953737
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DR LUIS S. NAVARRO PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/24/2010
-----------------------------------------------------
Last Update Date | 05/24/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2301 S HWY 281
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-3712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-383-5581
-----------------------------------------------------
Fax | 956-381-1218
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2301 S HWY 281
-----------------------------------------------------
City | EDINBURG
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78539-3712
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-383-5581
-----------------------------------------------------
Fax | 956-381-1218
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OPTOMETRIST/OWNER
-----------------------------------------------------
Name | DR. LUIS S NAVARRO
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 956-383-5581
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | 6970TG
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------