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General NPI Number Information
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NPI Number | 1497869796
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Entity Type | Organization
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Legal Business Name | RETINA ASSOCIATES OF SOUTH TEXAS, P.A.
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9910 HUEBNER RD SUITE 100
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1336
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Country | US
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Telephone | 210-615-7600
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Fax | 210-615-8505
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Provider Business Mailing Address
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Address Line | PO BOX 356
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City | SAN ANTONIO
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State | TX
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Zip | 78292-0356
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Country | US
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Telephone | 210-615-7600
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Fax | 210-615-8505
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Authorized Official
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Title or Position | PRESIDENT
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Name | TIMOTHY PAUL CLELAND
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Credential | M.D.
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Telephone | 210-615-7600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State | TX
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