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NPI Code Detail

MEDICARE: SCOTT K SITTERLE O.D.

MEDICARE: SCOTT K SITTERLE 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
1152W00000XOptometrist4343TGTX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1811930258
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT K SITTERLE O.D.
Provider Business Mailing Address
First Line : 2950 THOUSAND OAKS DR
Second Line : SUITE 23
City : SAN ANTONIO
State : TX
Zip : 78247-3361
Country : US
Telephone Number : 210-490-9091
Fax Number : 210-490-8355
Provider Business Practice Location Address
First Line : 2950 THOUSAND OAKS DR
Second Line : SUITE 23
City : SAN ANTONIO
State : TX
Zip : 78247-3361
Country : US
Telephone Number : 210-490-9091
Fax Number : 210-490-8355
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2006
Last Update Date : 05/05/2014

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