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NPI Code Detail

MEDICARE: ALEX PELAYO

MEDICARE:   ALEX  PELAYO
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
1156FX1800XOptician085071TX

General Provider Information

NPI Number : 1639862378
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALEX PELAYO
Provider Business Mailing Address
First Line : 602 CIBOLO VALLEY DR
Second Line :
City : CIBOLO
State : TX
Zip : 78108-3801
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 602 CIBOLO VALLEY DR
Second Line :
City : CIBOLO
State : TX
Zip : 78108-3801
Country : US
Telephone Number : 210-659-9213
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/30/2023
Last Update Date : 05/30/2023

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Directions to “ ALEX PELAYO ” Practice Location

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