Provider Demographics
NPI:1689918716
Name:MI VISION
Entity Type:Organization
Organization Name:MI VISION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRY DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:PEDRO
Authorized Official - Middle Name:A
Authorized Official - Last Name:CUBA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-928-2022
Mailing Address - Street 1:6915 S ZARZAMORA ST
Mailing Address - Street 2:SUITE 107 B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1100
Mailing Address - Country:US
Mailing Address - Phone:210-928-2022
Mailing Address - Fax:210-928-2023
Practice Address - Street 1:6915 S ZARZAMORA ST
Practice Address - Street 2:SUITE 107 B
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1100
Practice Address - Country:US
Practice Address - Phone:210-928-2022
Practice Address - Fax:210-928-2023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-15
Last Update Date:2012-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7796152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty