20-20 Crystal Clear Vision, P.a.

Primary specialty

OptometristTaxonomy code 152W00000X

License

6327TG Issued in TX

Legal business name

20-20 CRYSTAL CLEAR VISION, P.A.

Practice address

1706 SW Loop 410 Ste 102
San Antonio, TX 78227-1676

Phone

(210) 419-4300

NPI assigned

Apr 26, 2013

Last updated

Apr 26, 2013By 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. Edward Bustamante, O.D.

Title

Optometrist

Phone

(210) 419-4300

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1366934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1366934400000",
    "number": "1336583822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 SW LOOP 410 STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782271676",
            "telephone_number": "210-419-4300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 SW LOOP 410 STE 102",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782271676",
            "telephone_number": "210-419-4300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20-20 CRYSTAL CLEAR VISION, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-26",
        "last_updated": "2013-04-26",
        "status": "A",
        "authorized_official_last_name": "BUSTAMANTE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "OPTOMETRIST",
        "authorized_official_telephone_number": "210-419-4300",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "6327TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Apr 26, 2013; 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.