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General NPI Number Information
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NPI Number | 1407129927
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Entity Type | Organization
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Legal Business Name | ALAMO VISION ASSOCIATES, PC
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Dates
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Enumeration Date | 02/14/2012
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Last Update Date | 02/14/2012
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Provider Practice Location Address
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Address Line | 5619 W LOOP 1604 N STE 114
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City | SAN ANTONIO
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State | TX
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Zip | 78253-5795
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Country | US
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Telephone | 210-647-0728
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Fax | 210-681-5379
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Provider Business Mailing Address
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Address Line | 5619 W LOOP 1604 N STE 114
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City | SAN ANTONIO
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State | TX
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Zip | 78253-5795
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOHN K. NGUYEN
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Credential |
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Telephone | 210-647-0728
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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 | 6758TG
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License Number State | TX
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