| Shaenfield Vision Source Llc | |
|
7915 W 1604 N Ste 118 San Antonio TX 78254-9997 | |
| (832) 331-9831 | |
| Not Available |
| Full Name | Shaenfield Vision Source Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7915 W 1604 N, San Antonio, Texas |
| Authorized Official Name and Position | Thanh Tran (OWNER) |
| Authorized Official Contact | 8323319831 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shaenfield Vision Source Llc 9218 Potranco Rd Ste 105 San Antonio TX 78251-2274 Ph: () - | Shaenfield Vision Source Llc 7915 W 1604 N Ste 118 San Antonio TX 78254-9997 Ph: (832) 331-9831 |
| NPI Number | 1265984801 |
|---|---|
| Provider Enumeration Date | 10/31/2016 |
| Last Update Date | 10/31/2016 |
| Medicare PECOS PAC ID | 7012284771 |
|---|---|
| Medicare Enrollment ID | O20170530002627 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265984801 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Thanh Tran |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1265871784 PECOS PAC ID: 7618111899 Enrollment ID: I20130910000831 |
| Provider Name | Peter Nguyen |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1326472622 PECOS PAC ID: 1759510977 Enrollment ID: I20140211001778 |
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