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General NPI Number Information
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NPI Number | 1447012935
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Entity Type | Organization
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Legal Business Name | 20/15 VISION PLLC.
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Dates
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Enumeration Date | 01/29/2024
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 3302 SE MILITARY DR
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City | SAN ANTONIO
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State | TX
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Zip | 78223-3734
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Country | US
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Telephone | 210-330-6192
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Fax |
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Provider Business Mailing Address
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Address Line | 13925 TOBIANO TRL
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City | HELOTES
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State | TX
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Zip | 78023-2836
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Country | US
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Telephone | 210-330-6192
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. BOBI A GRAHAM
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Credential |
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Telephone | 210-330-6192
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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 |
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License Number State |
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