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General NPI Number Information
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NPI Number | 1598744005
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Entity Type | Individual
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Provider Name | THOMAS J. GOLDSTEIN O.D.
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Gender | Male
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Dates
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Enumeration Date | 01/12/2006
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Last Update Date | 09/11/2024
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Provider Practice Location Address
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Address Line | 1136 MAIN ST
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City | BANDERA
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State | TX
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Zip | 78003-3589
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Country | US
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Telephone | 830-850-0628
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Fax | 830-850-0346
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Provider Business Mailing Address
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Address Line | 3331 WURZBACH RD STE B
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City | SAN ANTONIO
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State | TX
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Zip | 78238-5138
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Country | US
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Telephone | 210-520-6353
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Fax | 210-522-0606
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 4652TG
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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 | 1134
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License Number State | OK
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