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General NPI Number Information
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NPI Number | 1932843943
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Entity Type | Organization
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Legal Business Name | CLM EYECARE PLLC
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Dates
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Enumeration Date | 04/25/2022
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Last Update Date | 04/25/2022
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Provider Practice Location Address
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Address Line | 20079 STONE OAK PKWY STE 1104
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City | SAN ANTONIO
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State | TX
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Zip | 78258-6943
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Country | US
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Telephone | 713-501-8907
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Fax |
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Provider Business Mailing Address
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Address Line | 20079 STONE OAK PKWY STE 1104
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City | SAN ANTONIO
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State | TX
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Zip | 78258-6943
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Country | US
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Telephone | 713-501-8907
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHANDLER ROBERT MANN II
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Credential | OD
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Telephone | 713-501-8907
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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 |
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License Number State |
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