Organization
RETINA SPECIALISTS OF SAN ANTONIO, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES D BRODRICK MD (OWNER)
(210) 271-7648
Entity
Organization
Contact information
Practice address
303 E QUINCY ST, SUITE 100, SAN ANTONIO, TX 78215-1918
(210) 271-7648
(210) 225-8184
Mailing address
303 E QUINCY ST, SUITE 100, SAN ANTONIO, TX 78215-1918
(210) 271-7648
(210) 225-8184
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
—
TX
207WX0107X
Retina Specialist (Ophthalmology) Physician
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3583817-01
—
TX
Enumeration date
02/17/2016
Last updated
04/25/2017
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