Organization
DR. W.R.ELIZONDO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM R. ELIZONDO (THERAPEUTIC OPTOMETRY DOCTOR)
(210) 736-4461
Entity
Organization
Contact information
Practice address
2219 CINCINNATI AVE, SAN ANTONIO, TX 78228-5134
(210) 736-4461
(210) 736-2156
Mailing address
2219 CINCINNATI AVE, SAN ANTONIO, TX 78228-5134
(210) 736-4461
(210) 736-2156
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1669T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0197535
—
TX
Enumeration date
03/29/2007
Last updated
02/29/2008
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