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General NPI Number Information
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NPI Number | 1881677110
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Entity Type | Individual
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Provider Name | ELSIE NOEMI DE LA TEXERA SR. OD
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Gender | Female
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Dates
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Enumeration Date | 11/21/2005
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Last Update Date | 04/27/2017
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Provider Practice Location Address
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Address Line | COHEN'S FASHION OPTICAL PLAZA CAROLINA AVE. JESUS M. FRAGOSO SUITE 245
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City | CAROLINA
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State | PR
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Zip | 00983
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Country | US
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Telephone | 787-701-3165
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Fax |
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Provider Business Mailing Address
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Address Line | 35 JUAN C. BORBON STE 67-113
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City | GUAYNABO
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State | PR
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Zip | 00969
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Country | US
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Telephone | 787-312-9815
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Fax |
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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 | 512
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License Number State | PR
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