Provider Demographics
NPI:1609159581
Name:EYE TO EYE VISION
Entity Type:Organization
Organization Name:EYE TO EYE VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPEUTIC OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LEYDEN
Authorized Official - Middle Name:E
Authorized Official - Last Name:SIANGHIO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-782-8205
Mailing Address - Street 1:1321 N LOOP 1604 E
Mailing Address - Street 2:SUITE 100-A
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-1437
Mailing Address - Country:US
Mailing Address - Phone:210-782-8205
Mailing Address - Fax:210-545-2147
Practice Address - Street 1:1321 N LOOP 1604 E
Practice Address - Street 2:SUITE 100-A
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78232-1437
Practice Address - Country:US
Practice Address - Phone:210-782-8205
Practice Address - Fax:210-545-2147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4416T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty