| Atascosa Vision Source,pa | |
|
1514 W Oaklawn Rd, Pleasanton, TX 78064-3830 | |
| (830) 569-8771 | |
| (830) 569-2346 |
| Full Name | Atascosa Vision Source,pa |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 1514 W Oaklawn Rd, Pleasanton, Texas |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104037415 | NPI | - | NPPES |
| P00227713 | Other | TX | PALMETTE GBA RAILROAD MEDIARE |
| 164513702 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | 05681TG (Texas) | Primary |
| Provider Name | Christopher M Prough |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1194139121 PECOS PAC ID: 0648491894 Enrollment ID: I20141031001646 |
| Mailing Address | Practice Location Address |
|---|---|
| Atascosa Vision Source,pa 1514 W Oaklawn Rd, Pleasanton, TX 78064-3830 Ph: (830) 569-8771 | Atascosa Vision Source,pa 1514 W Oaklawn Rd, Pleasanton, TX 78064-3830 Ph: (830) 569-8771 |
Dr. Christopher Mark Prough, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 1514 W Oaklawn Rd, Pleasanton, TX 78064 Phone: 830-569-8771 Fax: 830-569-2346 | |
Dr. Ron Dwaine Mixon, O.D. Optometrist Medicare: Accepting Medicare Assignments Practice Location: 2151 W Oaklawn Rd, Pleasanton, TX 78064 Phone: 830-569-3334 Fax: 830-281-3926 |