Provider Demographics
NPI:1942508858
Name:OPHTHALMOLOGY ASSOCIATES OF SAN ANTONIO DBA I.WEAR BY OASA
Entity Type:Organization
Organization Name:OPHTHALMOLOGY ASSOCIATES OF SAN ANTONIO DBA I.WEAR BY OASA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:A
Authorized Official - Last Name:CAMPAGNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-223-5561
Mailing Address - Street 1:1001 S MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-2831
Mailing Address - Country:US
Mailing Address - Phone:830-249-3241
Mailing Address - Fax:
Practice Address - Street 1:414 NAVARRO ST
Practice Address - Street 2:SUITE 401
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-2516
Practice Address - Country:US
Practice Address - Phone:210-225-5340
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPHTHALMOLOGY ASSOCIATES OF SAN ANTONIO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-03-02
Last Update Date:2011-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0575010002Medicare NSC