Individual
DR. VINCENT ANTHONY RESTIVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12171 W PARMER LN, SUITE 201, CEDAR PARK, TX 78613-7361
(512) 528-1144
(512) 528-1143
Mailing address
11901 W PARMER LN, STE 400, CEDAR PARK, TX 78613-7655
(512) 528-1144
(512) 528-1143
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
K6970
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143889702
—
TX
01
—
8S5180
BCBS OF TEXAS INDIVIDUAL #
TX
Enumeration date
01/23/2006
Last updated
05/06/2016
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