| Tso Bandera | |
|
9234 N Loop 1604 W, Ste 104, San Antonio, TX 78249-2983 | |
| (210) 417-4177 | |
| (210) 417-4178 |
| Full Name | Tso Bandera |
|---|---|
| Type | Facility |
| Speciality | Optometrist |
| Location | 9234 N Loop 1604 W, 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 |
|---|---|---|---|
| 1538530845 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 152W00000X | Optometrist | (Texas) | Primary |
| Provider Name | Jason R Egbert |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1235528936 PECOS PAC ID: 5698078657 Enrollment ID: I20160125002642 |
| Provider Name | Gladdis Thomas Page |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1225445158 PECOS PAC ID: 0749583714 Enrollment ID: I20160125002788 |
| Provider Name | Victoria Perez |
|---|---|
| Provider Type | Practitioner - Optometry |
| Provider Identifiers | NPI Number: 1164873667 PECOS PAC ID: 8123365863 Enrollment ID: I20190204000663 |
| Mailing Address | Practice Location Address |
|---|---|
| Tso Bandera 9234 N Loop 1604 W, Ste 104, San Antonio, TX 78249-2983 Ph: (210) 417-4177 | Tso Bandera 9234 N Loop 1604 W, Ste 104, San Antonio, TX 78249-2983 Ph: (210) 417-4177 |
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