Organization
MIRACLE VISION OPTICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ADRIAN CASTANEDA (CERTIFIED OPTICIAN)
(210) 337-5843
Entity
Organization
Contact information
Practice address
4042 MIHO, SAN ANTONIO, TX 78223-3822
(210) 337-5243
Mailing address
4042 MIHO, SAN ANTONIO, TX 78223-3822
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
DR4082
TX
Other
Enumeration date
11/24/2007
Last updated
11/24/2007
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