Individual
CESAR IVAN VENEGAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
896 HORIZON BLVD, SOCORRO, TX 79927-4787
(915) 226-4999
Mailing address
13299 MORISSEY WAY, EL PASO, TX 79928-5830
(915) 226-4999
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
B0115-2733
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
821591575
821591575
TX
Enumeration date
10/12/2017
Last updated
06/16/2018
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