Provider Demographics
NPI:1508840422
Name:BARBOSA TEXIDOR, LUIS E (OD)
Entity Type:Individual
Prefix:DR
First Name:LUIS
Middle Name:E
Last Name:BARBOSA TEXIDOR
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 61
Mailing Address - Street 2:
Mailing Address - City:DORADO
Mailing Address - State:PR
Mailing Address - Zip Code:00646-0061
Mailing Address - Country:US
Mailing Address - Phone:787-869-4600
Mailing Address - Fax:787-869-4600
Practice Address - Street 1:CARR 164 KM 7.7
Practice Address - Street 2:C. COMERCIAL JARDINES DE NARANJITO, LOCAL 1
Practice Address - City:NARANJITO
Practice Address - State:PR
Practice Address - Zip Code:00719
Practice Address - Country:US
Practice Address - Phone:787-869-4600
Practice Address - Fax:787-869-4600
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR603152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR0022423Medicare ID - Type Unspecified