Provider Demographics
NPI:1740665330
Name:PARTIDA WILLIS INC
Entity type:Organization
Organization Name:PARTIDA WILLIS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDRES
Authorized Official - Middle Name:
Authorized Official - Last Name:GARIBI
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:956-462-5254
Mailing Address - Street 1:519 E CALTON RD
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-3688
Mailing Address - Country:US
Mailing Address - Phone:956-462-5254
Mailing Address - Fax:956-462-5254
Practice Address - Street 1:519 E CALTON RD
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3688
Practice Address - Country:US
Practice Address - Phone:956-462-5254
Practice Address - Fax:956-462-5254
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-23
Last Update Date:2015-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Single Specialty