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General NPI Number Information
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NPI Number | 1881925196
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Entity Type | Organization
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Legal Business Name | MJW EYECARE ASSOCIATES, P.A.
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 04/19/2010
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Provider Practice Location Address
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Address Line | 2340 E MAIN ST STE Q
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City | UVALDE
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State | TX
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Zip | 78801-4945
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Country | US
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Telephone | 830-278-2010
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Fax | 830-278-1995
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Provider Business Mailing Address
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Address Line | 7311 STONEWALL HL
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City | SAN ANTONIO
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State | TX
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Zip | 78256-1667
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Country | US
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Telephone | 830-591-7595
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BOBBY WAYNE WOOD JR.
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Credential | O. D.
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Telephone | 830-591-7595
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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 | 5954TG
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License Number State | TX
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