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General NPI Number Information
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NPI Number | 1609663376
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Entity Type | Organization
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Legal Business Name | SAN ANTONIO EYE CENTER PA
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Dates
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Enumeration Date | 04/24/2025
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Last Update Date | 04/24/2025
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Provider Practice Location Address
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Address Line | 511 DALLAS ST
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1936
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Country | US
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Telephone | 210-226-6169
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Fax | 210-226-8365
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Provider Business Mailing Address
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Address Line | 800 MCCULLOUGH AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78215-1625
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Country | US
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Telephone | 210-226-6169
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALBERT CASTILLO
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Credential |
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Telephone | 210-226-6169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number |
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License Number State |
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