Provider Demographics
NPI:1174635304
Name:JURICA, ADAM R (OD)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:R
Last Name:JURICA
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Gender:M
Credentials:OD
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Mailing Address - Street 1:5488 S PADRE ISLAND DR
Mailing Address - Street 2:STE 2042
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-4147
Mailing Address - Country:US
Mailing Address - Phone:361-994-0310
Mailing Address - Fax:361-994-0452
Practice Address - Street 1:5488 S PADRE ISLAND DR
Practice Address - Street 2:STE 2042
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4147
Practice Address - Country:US
Practice Address - Phone:361-994-0310
Practice Address - Fax:361-994-0452
Is Sole Proprietor?:No
Enumeration Date:2006-09-01
Last Update Date:2010-04-21
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Provider Licenses
StateLicense IDTaxonomies
TX6936T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXV11987Medicare UPIN
TX00E74WMedicare PIN