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General NPI Number Information
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NPI Number | 1497471262
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Entity Type | Organization
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Legal Business Name | JAMES F ANDERSON, OD PLLC
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Dates
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Enumeration Date | 10/13/2022
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Last Update Date | 10/13/2022
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Provider Practice Location Address
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Address Line | 510 KITTY HAWK RD
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City | UNIVERSAL CITY
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State | TX
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Zip | 78148-3961
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Country | US
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Telephone | 210-774-5367
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Fax |
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Provider Business Mailing Address
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Address Line | 17711 KRUGERRAND DR
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City | SAN ANTONIO
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State | TX
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Zip | 78232-5626
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Country | US
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Telephone | 210-653-5665
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JAMES E ANDERSON
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Credential | OD
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Telephone | 210-774-5367
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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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