MEDICARE: E & S MANAGEMENT LLC

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	332H00000X	Eyewear Supplier

General Provider Information

NPI Number	:	1508347568
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E & S MANAGEMENT LLC

Provider Business Mailing Address
First Line	:	3008 DAWN DR STE 105
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78628-2822
Country	:	US
Telephone Number	:	210-774-5396
Fax Number	:	561-828-8367

Provider Business Practice Location Address
First Line	:	950 S GENERAL MCMULLEN DR STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78237-3135
Country	:	US
Telephone Number	:	561-275-2020
Fax Number	:

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	JACKIE BENNETT
Credential	:
Telephone Number	:	561-612-4531

Provider Enumeration Date	:	08/27/2018
Last Update Date	:	02/17/2021

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Directions to “E & S MANAGEMENT LLC ” Practice Location

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