Atascosa Vision Source,PA
Organization Active NPI Optometrist · Pleasanton, TX
NPI 1104037415 · NPPES record last updated Jul 25, 2008
Key facts
- NPI
- 1104037415
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 05681TG (TX)
- Legal business name
- ATASCOSA VISION SOURCE,PA
- Practice address
- 1514 W Oaklawn Rd
Pleasanton, TX 78064-3830 - Phone
- (830) 569-8771
- Fax
- (830) 569-2346
- NPI assigned
- May 25, 2007
- Organization subpart
- No
Authorized official
- Name
- Stephen Planchet, O.D.
- Title
- President
- Phone
- (830) 569-8771
Practitioners 1
-
Christopher Mark Prough, O.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 05681TG | TX | Yes |
Addresses
Primary practice location
1514 W Oaklawn Rd
Pleasanton, TX 78064-3830
Mailing address
1514 W Oaklawn Rd
Pleasanton, TX 78064-3830
Phone (830) 569-8771
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P00227713 | Other | TX | PALMETTE GBA RAILROAD MEDIARE |
| 164513702 | Medicaid | TX |
Other providers in Pleasanton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 25, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.