Provider Demographics
NPI:1033800792
Name:OCULAR ONCOLOGY AND MEDICAL RETINA P.A.
Entity Type:Organization
Organization Name:OCULAR ONCOLOGY AND MEDICAL RETINA P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ERICA
Authorized Official - Middle Name:
Authorized Official - Last Name:ALVAREZ GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:915-253-3625
Mailing Address - Street 1:3100 MONTANA AVE
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79903
Mailing Address - Country:US
Mailing Address - Phone:915-888-9145
Mailing Address - Fax:534-429-4340
Practice Address - Street 1:3100 MONTANA AVE
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79903
Practice Address - Country:US
Practice Address - Phone:915-888-9145
Practice Address - Fax:534-429-4340
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-15
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS0132XAmbulatory Health Care FacilitiesClinic/CenterOphthalmologic Surgery
No207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina SpecialistGroup - Multi-Specialty