MEDICARE: NEW BRAUNFELS TEXAS STATE OPTICAL, PLLC.

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
1	152W00000X	Optometrist	8234	TX

General Provider Information

NPI Number	:	1316464886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEW BRAUNFELS TEXAS STATE OPTICAL, PLLC.

Provider Business Mailing Address
First Line	:	2406 HUNTER RD STE 102
Second Line	:
City	:	SAN MARCOS
State	:	TX
Zip	:	78666-5256
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1705 S WALNUT AVE STE 100
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-1116
Country	:	US
Telephone Number	:	830-629-1248
Fax Number	:

Authorized Official
Title or Position	:	OPTOMETRIST
Name	:	DR. JESLYN SABOL
Credential	:	OD
Telephone Number	:	512-658-3079

Provider Enumeration Date	:	08/25/2017
Last Update Date	:	07/25/2023

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