Provider Demographics
NPI:1336476803
Name:RENEE TOMES DUNLAP, OD, PLLC
Entity Type:Organization
Organization Name:RENEE TOMES DUNLAP, OD, PLLC
Other - Org Name:TEXAS STATE OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER/OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:TOMES
Authorized Official - Last Name:DUNLAP
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-698-0639
Mailing Address - Street 1:27815 WOODLAND GREEN
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015
Mailing Address - Country:US
Mailing Address - Phone:210-698-0639
Mailing Address - Fax:
Practice Address - Street 1:21019 US HWY 281
Practice Address - Street 2:SUITE 832
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258
Practice Address - Country:US
Practice Address - Phone:210-698-0639
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-04
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7303TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty