Dr. W.R.Elizondo

Primary specialty

OptometristTaxonomy code 152W00000X

License

1669T Issued in TX

Legal business name

DR. W.R.ELIZONDO

Practice address

2219 Cincinnati Ave
San Antonio, TX 78228-5134

Phone

(210) 736-4461

Fax

(210) 736-2156

NPI assigned

Mar 29, 2007

Last updated

Feb 29, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. William R. ElizondoNPI 1417127168

Title

Therapeutic Optometry Doctor

Phone

(210) 736-4461

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• William R Elizondo, OD

  • Optometrist
  • San Antonio, TX
  • NPI 1417127168
  NPD (past) Authorized official

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1204243200000",
    "number": "1336269943",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 CINCINNATI AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782285134",
            "telephone_number": "210-736-4461",
            "fax_number": "210-736-2156"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 CINCINNATI AVE",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782285134",
            "telephone_number": "210-736-4461",
            "fax_number": "210-736-2156"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. W.R.ELIZONDO",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-29",
        "last_updated": "2008-02-29",
        "status": "A",
        "authorized_official_last_name": "ELIZONDO",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "THERAPEUTIC OPTOMETRY DOCTOR",
        "authorized_official_telephone_number": "210-736-4461",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "1669T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0197535",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.