Organization
OCVT SO CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIANA M LARSON D.O. (CEO)
(210) 490-9900
Entity
Organization
Contact information
Practice address
255 E SONTERRA BLVD, SUITE 100, SAN ANTONIO, TX 78258-4075
(210) 490-9900
Mailing address
255 E SONTERRA BLVD, SUITE 100, SAN ANTONIO, TX 78258-4075
(210) 490-9900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
7197T
TX
152WV0400X
Vision Therapy Optometrist
Primary
7197
TX
Other
Enumeration date
04/22/2016
Last updated
04/22/2016
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