20-20 Crystal Clear Vision PA

Primary specialty

OptometristTaxonomy code 152W00000X

Legal business name

20-20 CRYSTAL CLEAR VISION PA

Practice address

10004 Wurzbach Rd
San Antonio, TX 78230-2214

Phone

(210) 563-9694

NPI assigned

Dec 1, 2008

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.,M.B.A

Title

President

Phone

(210) 563-9694

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1272499200000",
    "number": "1962657205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 781603",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782781603",
            "telephone_number": "210-563-9694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10004 WURZBACH RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782302214",
            "telephone_number": "210-563-9694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "20-20 CRYSTAL CLEAR VISION PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-01",
        "last_updated": "2010-04-29",
        "status": "A",
        "authorized_official_last_name": "BUSTAMANTE",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "210-563-9694",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D.,M.B.A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "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 29, 2010; 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.