Active NPI
Edward Nolan Rendon II, ABOC NCLE
- Optician
- San Antonio, TX
National Provider Identifier
1750075800
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optician
- License
- NA
- Practice address
- 4331 Thousand Oaks Dr
San Antonio, TX 78217-2101 - Phone
- (210) 591-4981
- Fax
- (210) 650-0009
- NPI assigned
- Jun 2, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | NA | TX | Primary |
Addresses
Primary practice location
4331 Thousand Oaks Dr
San Antonio, TX 78217-2101
Mailing address
4331 Thousand Oaks Dr
San Antonio, TX 78217-2101
Phone (210) 591-4981
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1685664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1685664000000",
"number": "1750075800",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4331 THOUSAND OAKS DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782172101",
"telephone_number": "210-591-4981",
"fax_number": "210-650-0009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4331 THOUSAND OAKS DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "782172101",
"telephone_number": "210-591-4981",
"fax_number": "210-650-0009"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RENDON",
"first_name": "EDWARD",
"middle_name": "NOLAN",
"name_suffix": "II",
"credential": "ABOC NCLE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-02",
"last_updated": "2023-06-02",
"certification_date": "2023-06-02",
"status": "A"
},
"taxonomies": [
{
"code": "156FX1800X",
"taxonomy_group": "",
"desc": "Technician/Technologist, Optician",
"state": "TX",
"license": "NA",
"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 Jun 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.