Organization
MEDICAL CENTER OPHTHALMOLOGY ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CANDICE B DAVIS (CHIEF REVENUE CYCLE OFFICER)
(916) 990-7590
Entity
Organization
Contact information
Practice address
9157 HUEBNER RD, SAN ANTONIO, TX 78240-1502
(210) 697-2020
(210) 697-2026
Mailing address
500 ROSS ST 154-0455 BOX 360584, PITTSBURGH, PA 15262-0001
(210) 697-2020
(210) 697-2026
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
207W00000X
Ophthalmology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00HV39
MEDICARE GRP B
TX
05
—
083052302
—
TX
Enumeration date
06/20/2005
Last updated
02/10/2025
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