Provider Demographics
NPI:1073645958
Name:MEDINA VISION ASSOCIATES, PLLC
Entity Type:Organization
Organization Name:MEDINA VISION ASSOCIATES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:HORNER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:830-741-8555
Mailing Address - Street 1:109 22ND STREET
Mailing Address - Street 2:
Mailing Address - City:HONDO
Mailing Address - State:TX
Mailing Address - Zip Code:78861-2514
Mailing Address - Country:US
Mailing Address - Phone:830-741-8555
Mailing Address - Fax:830-741-8557
Practice Address - Street 1:109 22ND STREET
Practice Address - Street 2:
Practice Address - City:HONDO
Practice Address - State:TX
Practice Address - Zip Code:78861-2514
Practice Address - Country:US
Practice Address - Phone:830-741-8555
Practice Address - Fax:830-741-8557
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5668TG152W00000X
TX4440T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty