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General NPI Number Information
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NPI Number | 1306269014
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Entity Type | Organization
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Legal Business Name | CAIA D. HOMERSTAD OD PLLC
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Dates
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Enumeration Date | 01/31/2014
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Last Update Date | 01/31/2014
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Provider Practice Location Address
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Address Line | 7508 N NAVARRO ST
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City | VICTORIA
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State | TX
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Zip | 77904-2654
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Country | US
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Telephone | 361-212-4308
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Fax | 361-576-0806
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Provider Business Mailing Address
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Address Line | 106 WILSHIRE DR
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City | VICTORIA
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State | TX
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Zip | 77904-1854
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Country | US
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Telephone | 361-582-0283
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Fax | 361-576-0806
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. CAIA DAWN HOMERSTAD WILLIAMS
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Credential | OD
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Telephone | 361-212-4308
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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 | 5250TG
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License Number State | TX
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