Organization
ATASCOSA VISION SOURCE,PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN PLANCHET O.D. (PRESIDENT)
(830) 569-8771
Entity
Organization
Contact information
Practice address
1514 W OAKLAWN RD, PLEASANTON, TX 78064-3830
(830) 569-8771
(830) 569-2346
Mailing address
1514 W OAKLAWN RD, PLEASANTON, TX 78064-3830
(830) 569-8771
(830) 569-2346
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
05681TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
164513702
—
TX
01
—
P00227713
PALMETTE GBA RAILROAD MEDIARE
TX
Enumeration date
05/25/2007
Last updated
07/25/2008
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