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NPI Code Detail

MEDICARE: FSO, INC.

MEDICARE: FSO, 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
1332H00000XEyewear Supplier

General Provider Information

NPI Number : 1700145133
Entity Type Code : Organization
Provider Name (Legal Business Name) : FSO, INC.
Provider Business Mailing Address
First Line : 2620 HARRY WURZBACH RD
Second Line : SUITE 102
City : SAN ANTONIO
State : TX
Zip : 78209-5004
Country : US
Telephone Number : 210-828-2249
Fax Number : 210-828-2599
Provider Business Practice Location Address
First Line : 2620 HARRY WURZBACH RD
Second Line : SUITE 102
City : SAN ANTONIO
State : TX
Zip : 78209-5004
Country : US
Telephone Number : 210-828-2249
Fax Number : 210-828-2599
Authorized Official
Title or Position : MANAGER
Name : CHRIS KING
Credential :
Telephone Number : 210-828-2249
Provider Enumeration Date : 05/04/2012
Last Update Date : 05/04/2012

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Directions to “FSO, INC. ” Practice Location

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