Provider Demographics
NPI:1225350754
Name:THOMAS H. AYRES, O.D.,P.C.
Entity Type:Organization
Organization Name:THOMAS H. AYRES, O.D.,P.C.
Other - Org Name:OLMOS PARK VISION CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:H
Authorized Official - Last Name:AYRES
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-340-5822
Mailing Address - Street 1:4501 MCCULLOUGH AVE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-1660
Mailing Address - Country:US
Mailing Address - Phone:210-340-5822
Mailing Address - Fax:210-340-3841
Practice Address - Street 1:4501 MCCULLOUGH AVE
Practice Address - Street 2:SUITE #101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-1660
Practice Address - Country:US
Practice Address - Phone:210-340-5822
Practice Address - Fax:210-340-3841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1898T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTX2009323066OtherTRACKING NO: ORIGINAL APPLICATION
TX8F2441Medicare PIN
TXTX2009323066OtherTRACKING NO: ORIGINAL APPLICATION