Provider Demographics
NPI:1871223180
Name:PENAFIEL, EDUARDO (ABOC)
Entity Type:Individual
Prefix:
First Name:EDUARDO
Middle Name:
Last Name:PENAFIEL
Suffix:
Gender:M
Credentials:ABOC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25461 WHITE OAK LN
Mailing Address - Street 2:
Mailing Address - City:SPLENDORA
Mailing Address - State:TX
Mailing Address - Zip Code:77372-5339
Mailing Address - Country:US
Mailing Address - Phone:832-694-5719
Mailing Address - Fax:
Practice Address - Street 1:25461 WHITE OAK LN
Practice Address - Street 2:
Practice Address - City:SPLENDORA
Practice Address - State:TX
Practice Address - Zip Code:77372-5339
Practice Address - Country:US
Practice Address - Phone:832-599-3824
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-10
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician