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NPI Code Detail

MEDICARE: KEVIN W GREEMAN O.D.

MEDICARE: KEVIN W GREEMAN O.D.
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
1152W00000XOptometrist6585TGTX

General Provider Information

NPI Number : 1316909807
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN W GREEMAN O.D.
Provider Business Mailing Address
First Line : 249 E HILDEBRAND AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-2402
Country : US
Telephone Number : 210-824-4503
Fax Number : 210-824-2542
Provider Business Practice Location Address
First Line : 249 E HILDEBRAND AVE
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78212-2402
Country : US
Telephone Number : 210-824-4503
Fax Number : 210-824-2542
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/03/2006
Last Update Date : 06/05/2013

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