Provider Demographics
NPI:1932452968
Name:DR ROSA C SUAREZ-REYNA AND ASSOCIATES
Entity Type:Organization
Organization Name:DR ROSA C SUAREZ-REYNA AND ASSOCIATES
Other - Org Name:NORTHWEST FAMILY EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OD
Authorized Official - Prefix:
Authorized Official - First Name:ROSA
Authorized Official - Middle Name:C
Authorized Official - Last Name:SUAREZ-REYNA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:210-521-2085
Mailing Address - Street 1:6450 NW LOOP 410
Mailing Address - Street 2:SUITE 115
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-4209
Mailing Address - Country:US
Mailing Address - Phone:210-521-2085
Mailing Address - Fax:210-519-0962
Practice Address - Street 1:6450 NW LOOP 410
Practice Address - Street 2:SUITE 115
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-4209
Practice Address - Country:US
Practice Address - Phone:210-521-2085
Practice Address - Fax:210-519-0962
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6958TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty