Organization
PHYSICIANS EYE CLINIC OF LAREDO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN A MCNUTT M.D. (PRESIDENT)
(443) 695-3856
Entity
Organization
Contact information
Practice address
6999 MCPHERSON RD STE 216, LAREDO, TX 78041-6450
(956) 401-6615
(956) 410-5304
Mailing address
6999 MCPHERSON RD STE 216, LAREDO, TX 78041-6450
(956) 401-6615
(956) 410-5304
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
Q7580
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295311223
DR. MOTA NPI
TX
01
—
1720305642
NPI INDIVIDUAL
TX
01
—
Q7580
TX LICENSE
TX
Enumeration date
07/07/2017
Last updated
12/14/2022
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