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General NPI Number Information
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NPI Number | 1649921750
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Entity Type | Organization
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Legal Business Name | DANIEL POTH, O.D. AND ASSOCIATES P.C.
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Dates
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Enumeration Date | 01/11/2022
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Last Update Date | 02/14/2022
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Provider Practice Location Address
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Address Line | 1460 CENTRAL PARK BLVD STE 100
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City | FREDERICKSBURG
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State | VA
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Zip | 22401-4961
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Country | US
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Telephone | 540-291-7362
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Fax | 540-785-1411
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Provider Business Mailing Address
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Address Line | 175 E HOUSTON ST
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2299
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DOLSIE MCDONALD
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Credential |
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Telephone | 210-524-6663
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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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