Provider Demographics
NPI:1679129043
Name:ATHENA EYE INSTITUTE PLLC
Entity Type:Organization
Organization Name:ATHENA EYE INSTITUTE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHVINI
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-780-7595
Mailing Address - Street 1:3512 PAESANOS PKWY STE 203
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78231-1246
Mailing Address - Country:US
Mailing Address - Phone:210-780-7595
Mailing Address - Fax:210-519-3172
Practice Address - Street 1:3512 PAESANOS PKWY STE 203
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78231-1246
Practice Address - Country:US
Practice Address - Phone:210-780-7595
Practice Address - Fax:210-519-3172
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-12
Last Update Date:2020-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty