| NPI | 1609220995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIANA M LARSON CEO 210-490-9900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152WV0400X Optometrist, Vision Therapy (Licence: TX 7197) |
| Additional Taxonomies | 152W00000X Optometrist (Licence: TX 7197T) |
| Enumeration Date | 2016-04-22 |
| Last Update Date | 2016-04-22 |