Organization Active NPI

Beverly Ann Kotara Wiatrek, OD

  • Optometrist
  • San Antonio, TX
National Provider Identifier
1528089398
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
Legal business name
BEVERLY ANN KOTARA WIATREK, OD
Practice address
3310 E Southcross Blvd
San Antonio, TX 78223-1922
Phone
(210) 534-8863
Fax
(210) 534-8551
NPI assigned
Jul 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Beverly Wiatrek, O.D.
Title
Owner
Phone
(210) 534-8863

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
OptometristGroup: 193400000X SINGLE SPECIALTY GROUP 152W00000X Primary

Addresses

Primary practice location

3310 E Southcross Blvd
San Antonio, TX 78223-1922

Mailing address

3310 E Southcross Blvd
San Antonio, TX 78223-1922
Phone (210) 534-8863

National Provider Directory

National Provider Directory

Locations

3310 E Southcross Blvd
San Antonio, TX 78223
Phone (210) 534-8863

NPI Registry JSON

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1528089398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 E SOUTHCROSS BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782231922",
            "telephone_number": "210-534-8863",
            "fax_number": "210-534-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3310 E SOUTHCROSS BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782231922",
            "telephone_number": "210-534-8863",
            "fax_number": "210-534-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEVERLY ANN KOTARA WIATREK, OD",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WIATREK",
        "authorized_official_first_name": "BEVERLY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "210-534-8863",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.