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General NPI Number Information
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NPI Number | 1417315672
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Entity Type | Organization
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Legal Business Name | NEVELOW EYE ASSOCIATES
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Dates
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Enumeration Date | 02/03/2016
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Last Update Date | 08/30/2016
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Provider Practice Location Address
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Address Line | 19190 STONE OAK PKWY SUITE 120
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3237
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Country | US
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Telephone | 210-349-2437
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Fax | 210-494-1633
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Provider Business Mailing Address
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Address Line | 19190 STONE OAK PKWY SUITE 120
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City | SAN ANTONIO
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State | TX
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Zip | 78258-3237
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Country | US
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Telephone | 210-349-2437
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Fax | 210-494-1633
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN M NEVELOW
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Credential | OD
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Telephone | 210-349-2437
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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 | 6756-TG
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 2061-TG
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License Number State | TX
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