Provider Demographics
NPI:1790960029
Name:THE EYE DOCTOR
Entity Type:Organization
Organization Name:THE EYE DOCTOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:HINOJOSA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-922-2326
Mailing Address - Street 1:1121 SW MILITARY DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-1652
Mailing Address - Country:US
Mailing Address - Phone:210-922-2326
Mailing Address - Fax:210-922-2327
Practice Address - Street 1:1121 SW MILITARY DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1652
Practice Address - Country:US
Practice Address - Phone:210-922-2326
Practice Address - Fax:210-922-2327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-05
Last Update Date:2008-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4094T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty