Organization
20-20 CRYSTAL CLEAR VISION, P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD BUSTAMANTE O.D. (OPTOMETRIST)
(210) 419-4300
Entity
Organization
Contact information
Practice address
1706 SW LOOP 410 STE 102, SAN ANTONIO, TX 78227-1676
(210) 419-4300
Mailing address
1706 SW LOOP 410 STE 102, SAN ANTONIO, TX 78227-1676
(210) 419-4300
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6327TG
TX
Other
Enumeration date
04/26/2013
Last updated
04/26/2013
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