Individual
MARLAN G ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
15677 SAN PEDRO AVE, B, SAN ANTONIO, TX 78232-3732
(210) 490-9205
(210) 490-3633
Mailing address
PO BOX 160308, SAN ANTONIO, TX 78280-2508
(210) 366-1199
(210) 349-7111
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3004TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
112381203
—
TX
Enumeration date
06/07/2006
Last updated
06/11/2008
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