Provider Demographics
NPI:1700089471
Name:FERTIG, STEVE K (OD)
Entity Type:Individual
Prefix:DR
First Name:STEVE
Middle Name:K
Last Name:FERTIG
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 S 10TH ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-5433
Mailing Address - Country:US
Mailing Address - Phone:956-630-3103
Mailing Address - Fax:956-928-1841
Practice Address - Street 1:2204 S 10TH ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-5433
Practice Address - Country:US
Practice Address - Phone:956-630-3103
Practice Address - Fax:956-928-1841
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3785152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist