Provider Demographics
NPI:1720194228
Name:MICHAEL J. YUCHNITZ
Entity Type:Organization
Organization Name:MICHAEL J. YUCHNITZ
Other - Org Name:MY ECONOS 39 95 OPTICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ACCOUNT EXECUTIVE
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:NEMEROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-798-0169
Mailing Address - Street 1:1706 SW LOOP 410
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78227-1675
Mailing Address - Country:US
Mailing Address - Phone:210-673-3995
Mailing Address - Fax:210-523-1552
Practice Address - Street 1:1706 SW LOOP 410
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78227-1675
Practice Address - Country:US
Practice Address - Phone:210-673-3995
Practice Address - Fax:210-523-1552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX052503156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty