| |
7400 Louis Pasteur Dr Ste 200, San Antonio, TX 78229-4542 | |
(210) 614-3333 | |
(210) 697-9952 |
Full Name | |
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Type | Facility |
Speciality | Ophthalmology |
Location | 7400 Louis Pasteur Dr Ste 200, San Antonio, Texas |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1861602583 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
152W00000X | Optometrist | (* (Not Available)) | Secondary |
207W00000X | Ophthalmology | (* (Not Available)) | Primary |
Provider Name | Timithy M Dunham |
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Provider Type | Practitioner - Ophthalmology |
Provider Identifiers | NPI Number: 1477569424 PECOS PAC ID: 1951391689 Enrollment ID: I20040514000905 |
Mailing Address | Practice Location Address |
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7400 Louis Pasteur Dr Ste 200, San Antonio, TX 78229-4542 Ph: (210) 614-3333 | 7400 Louis Pasteur Dr Ste 200, San Antonio, TX 78229-4542 Ph: (210) 614-3333 |