Individual
MS. JEANNINE E CAMACHO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D
Contact information
Practice address
2929 MOSSROCK, SUITE 104, SAN ANTONIO, TX 78230-5141
(210) 377-0350
(210) 377-2982
Mailing address
2929 MOSSROCK, SUITE 104, SAN ANTONIO, TX 78230-5141
(210) 377-0350
(210) 377-2982
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7546T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213703602
—
TX
01
—
7546T
TEXAS OPTOMETRY BOARD LICENSE
TX
Enumeration date
07/14/2010
Last updated
10/12/2011
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