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NPI Code Detail

MEDICARE: LOS FRESNOS EYE CLINIC & OPTICAL INC.

MEDICARE: LOS FRESNOS EYE CLINIC & OPTICAL INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist6913TGTX

General Provider Information

NPI Number : 1215115118
Entity Type Code : Organization
Provider Name (Legal Business Name) : LOS FRESNOS EYE CLINIC & OPTICAL INC.
Provider Business Mailing Address
First Line : 810 W OCEAN BLVD STE C2
Second Line :
City : LOS FRESNOS
State : TX
Zip : 78566-3644
Country : US
Telephone Number : 956-233-5252
Fax Number : 956-233-6430
Provider Business Practice Location Address
First Line : 810 W OCEAN BLVD STE C2
Second Line :
City : LOS FRESNOS
State : TX
Zip : 78566-3644
Country : US
Telephone Number : 956-233-5252
Fax Number : 956-233-6430
Authorized Official
Title or Position : OWNER
Name : DR. ANTONIO VASQUEZ
Credential : OD
Telephone Number : 956-233-5252
Provider Enumeration Date : 02/04/2008
Last Update Date : 02/11/2008

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Directions to “LOS FRESNOS EYE CLINIC & OPTICAL INC. ” Practice Location

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