1780728790 NPI number — OPHTHALMOLOGY ASSOCIATES OF SAN ANTONIO DBA I.WEAR BY OASA

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780728790 NPI number — OPHTHALMOLOGY ASSOCIATES OF SAN ANTONIO DBA I.WEAR BY OASA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OPHTHALMOLOGY ASSOCIATES OF SAN ANTONIO DBA I.WEAR BY OASA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1780728790
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1804 NE LOOP 410
Provider Second Line Business Mailing Address:
270
Provider Business Mailing Address City Name:
SAN ANTONIO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78217-5215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
210-829-8781
Provider Business Mailing Address Fax Number:
210-930-3112

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
414 NAVARRO ST
Provider Second Line Business Practice Location Address:
401
Provider Business Practice Location Address City Name:
SAN ANTONIO
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78205-2516
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
210-225-5340
Provider Business Practice Location Address Fax Number:
210-225-5716
Provider Enumeration Date:
02/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CAMPAGNA
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
A
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
21022335561

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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