Provider Demographics
NPI:1275958712
Name:ANDROZO ENTERPRISES, PLLC
Entity Type:Organization
Organization Name:ANDROZO ENTERPRISES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FROGOZO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-403-9050
Mailing Address - Street 1:1742 N LOOP 1604 E STE 118
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1594
Mailing Address - Country:US
Mailing Address - Phone:210-403-9050
Mailing Address - Fax:
Practice Address - Street 1:1742 N LOOP 1604 E STE 118
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1594
Practice Address - Country:US
Practice Address - Phone:210-403-9050
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-02-20
Last Update Date:2014-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7706TG152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX347322Medicare PIN