Mario a. Caballero OD PC

Primary specialty

Corneal and Contact Management OptometristTaxonomy code 152WC0802X

License

4921TG Issued in TX

Legal business name

MARIO A. CABALLERO OD PC

Doing business as

Eastside Vision Center

Practice address

10952 Ben Crenshaw Dr
El Paso, TX 79935-3043

Phone

(915) 592-8090

Fax

(915) 592-9284

NPI assigned

Oct 6, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Mario A Caballero, O.D.NPI 1760444293

Title

President

Phone

(915) 592-8090

Specialties & licenses 1

Addresses

Other names 1

• Eastside Vision Center Doing business as

Medicare fee-for-service enrollment

Enrolled in TX

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mario A Caballero, O.D.

  • Corneal and Contact Management Optometrist
  • El Paso, TX
  • NPI 1760444293
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1223251200000",
    "number": "1114178316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10952 BEN CRENSHAW DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799353043",
            "telephone_number": "915-592-8090",
            "fax_number": "915-592-9284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10952 BEN CRENSHAW DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799353043",
            "telephone_number": "915-592-8090",
            "fax_number": "915-592-9284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIO A. CABALLERO OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-10-06",
        "last_updated": "2008-10-06",
        "status": "A",
        "authorized_official_last_name": "CABALLERO",
        "authorized_official_first_name": "MARIO",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "915-592-8090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152WC0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist, Corneal and Contact Management",
            "state": "TX",
            "license": "4921TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Eastside Vision Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rodolfo Marin Jr., PTA
• Samantha Marin
• Marina Aesthetic Institute PLLC
• Daniela Marines
• Tara Cathryn Marino, APRN
• Mario M. Padilla, M.D., P.a.
• Denisse A Marioni
• Luis R Marioni, DC
• Noe Marioni, M.D.
• Jonathan Guillermo Mariscal Quintana, MD

• Corneal and Contact Management Optometrist in El Paso, TX
• Providers in El Paso, TX by specialty
• Corneal and Contact Management Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.