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General NPI Number Information
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NPI Number | 1386837904
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Entity Type | Organization
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Legal Business Name | OPTICAL REFLECTIONS PLLC
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Dates
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Enumeration Date | 08/27/2007
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 1506 E 6TH ST
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City | WESLACO
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State | TX
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Zip | 78596-6606
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Country | US
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Telephone | 956-968-3302
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Fax | 956-968-4403
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Provider Business Mailing Address
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Address Line | 1506 E 6TH ST
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City | WESLACO
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State | TX
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Zip | 78596-6606
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Country | US
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Telephone | 956-968-3302
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Fax | 956-968-4403
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. ROLANDO R RIOS
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Credential | OD
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Telephone | 956-968-3302
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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 | 2753TG
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License Number State | TX
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