Organization
PRISCILLA R HEREDIA OD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PRISCILLA ROSE HEREDIA OD (CEO)
(830) 352-3050
Entity
Organization
Contact information
Practice address
708 S BIBB AVE, EAGLE PASS, TX 78852-5069
(830) 773-7339
(830) 773-4618
Mailing address
708 S BIBB AVE, EAGLE PASS, TX 78852-5069
(830) 773-7339
(830) 773-4618
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
Other
Enumeration date
02/03/2021
Last updated
02/08/2021
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