Provider Demographics
NPI:1790951150
Name:VISION ASSOCIATES OF SOUTH TEXAS
Entity Type:Organization
Organization Name:VISION ASSOCIATES OF SOUTH TEXAS
Other - Org Name:SOUTH TEXAS EYE INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-692-1388
Mailing Address - Street 1:2424 BABCOCK RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-6031
Mailing Address - Country:US
Mailing Address - Phone:210-692-1388
Mailing Address - Fax:210-692-1629
Practice Address - Street 1:2424 BABCOCK RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-6031
Practice Address - Country:US
Practice Address - Phone:210-692-1388
Practice Address - Fax:210-692-1629
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-06
Last Update Date:2011-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5455207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty