Organization
20-20 CRYSTAL CLEAR VISION PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWARD BUSTAMANTE O.D.,M.B.A (PRESIDENT)
(210) 563-9694
Entity
Organization
Contact information
Practice address
10004 WURZBACH RD, SAN ANTONIO, TX 78230-2214
(210) 563-9694
Mailing address
PO BOX 781603, SAN ANTONIO, TX 78278-1603
(210) 563-9694
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Enumeration date
12/01/2008
Last updated
04/29/2010
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