MEDICARE: AMMON DON GARNER 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
1	152W00000X	Optometrist	8015T	TX

General Provider Information

NPI Number	:	1881958619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMMON DON GARNER O.D.

Provider Business Mailing Address
First Line	:	3800 N MESA ST
Second Line	:	B-1
City	:	EL PASO
State	:	TX
Zip	:	79902-1538
Country	:	US
Telephone Number	:	915-533-1811
Fax Number	:	915-533-3641

Provider Business Practice Location Address
First Line	:	3800 N MESA ST
Second Line	:	B-1
City	:	EL PASO
State	:	TX
Zip	:	79902-1538
Country	:	US
Telephone Number	:	915-533-1811
Fax Number	:	915-533-3641

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/26/2012
Last Update Date	:	01/04/2024

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