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General NPI Number Information
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NPI Number | 1962422774
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Entity Type | Organization
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Legal Business Name | RACHEL DURAN TELLEZ OD PA
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Dates
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Enumeration Date | 07/21/2006
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Last Update Date | 09/18/2009
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Provider Practice Location Address
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Address Line | 24165 W IH 10 STE 229
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1159
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Country | US
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Telephone | 201-069-8788
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Fax | 210-698-7886
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Provider Business Mailing Address
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Address Line | 24165 W IH 10 STE 229
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City | SAN ANTONIO
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State | TX
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Zip | 78257-1159
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Country | US
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Telephone | 201-069-8788
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Fax | 210-698-7886
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Authorized Official
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Title or Position | OWNER
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Name | RACHEL D TELLEZ
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Credential | O.D.
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Telephone | 210-698-7884
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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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