Provider Demographics
NPI:1114282050
Name:MEDICAL CENTER OPHTHALMOLOGY ASSOCIATES
Entity Type:Organization
Organization Name:MEDICAL CENTER OPHTHALMOLOGY ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPHTHALMOLOGIST/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-697-2020
Mailing Address - Street 1:9157 HUEBNER RD
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-1502
Mailing Address - Country:US
Mailing Address - Phone:210-697-2020
Mailing Address - Fax:210-558-7679
Practice Address - Street 1:11212 STATE HIGHWAY 151
Practice Address - Street 2:PLAZA II, SUITE 150
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4498
Practice Address - Country:US
Practice Address - Phone:210-697-2020
Practice Address - Fax:210-558-7679
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-06
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083052302Medicaid
TX1659376226OtherNPI
TX00HV39OtherMEDICARE GROUP B