Active NPI
Beverly Ann Kotara Wiatrek, OD
- Optometrist
- San Antonio, TX
National Provider Identifier
1528089398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 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 DirectoryLocations
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.