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General NPI Number Information
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NPI Number | 1932181641
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Entity Type | Organization
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Legal Business Name | SOUTH TEXAS EYE ASSOCIATES
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Dates
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Enumeration Date | 11/17/2005
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Last Update Date | 09/17/2010
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Provider Practice Location Address
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Address Line | 4406 N LAURENT
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City | VICTORIA
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State | TX
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Zip | 77901-2791
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Country | US
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Telephone | 361-578-0107
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Fax | 361-578-1320
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Provider Business Mailing Address
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Address Line | 4406 N LAURENT
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City | VICTORIA
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State | TX
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Zip | 77901-2791
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Country | US
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Telephone | 361-578-0107
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Fax | 361-578-1320
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | DR. ROBERT T MCMAHON
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Credential | MD
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Telephone | 361-578-0107
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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