Provider Demographics
NPI:1225329121
Name:SAN ANTONIO EYE CENTER, P.A.
Entity Type:Organization
Organization Name:SAN ANTONIO EYE CENTER, P.A.
Other - Org Name:IDOC OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-226-6169
Mailing Address - Street 1:14807 SAN PEDRO AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-3708
Mailing Address - Country:US
Mailing Address - Phone:210-495-2020
Mailing Address - Fax:210-495-4500
Practice Address - Street 1:2424 BABCOCK RD
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6031
Practice Address - Country:US
Practice Address - Phone:210-616-0174
Practice Address - Fax:210-692-1629
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SAN ANTONIO EYE CENTER, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-04-26
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies