Provider Demographics
NPI:1629227038
Name:RONALD NEWTON OD
Entity Type:Organization
Organization Name:RONALD NEWTON OD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:B
Authorized Official - Last Name:NEWTON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:956-765-6786
Mailing Address - Street 1:609 SALINAS AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-5751
Mailing Address - Country:US
Mailing Address - Phone:956-765-6786
Mailing Address - Fax:956-765-6883
Practice Address - Street 1:501 N US HIGHWAY 83
Practice Address - Street 2:
Practice Address - City:ZAPATA
Practice Address - State:TX
Practice Address - Zip Code:78076-3259
Practice Address - Country:US
Practice Address - Phone:956-765-6786
Practice Address - Fax:956-765-6883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-09-10
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3203TG152W00000X
332B00000X, 332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332H00000XSuppliersEyewear SupplierGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135219708Medicaid
TX135219702Medicaid
0948870001Medicare NSC
TXT15035Medicare UPIN
TX135219702Medicaid