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General NPI Number Information
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NPI Number | 1629010673
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Entity Type | Individual
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Provider Name | RENE ALTAMIRANO O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/12/2006
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Last Update Date | 05/12/2016
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Provider Practice Location Address
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Address Line | 803 SW MILITARY DR SUITE 120
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City | SAN ANTONIO
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State | TX
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Zip | 78221-1528
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Country | US
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Telephone | 210-924-0177
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Fax | 210-924-4729
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Provider Business Mailing Address
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Address Line | 910 SE MILITARY DR STE 120
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City | SAN ANTONIO
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State | TX
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Zip | 78214-2875
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Country | US
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Telephone | 210-924-0177
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Fax | 210-924-4729
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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 | 5609TG
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License Number State | TX
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