Provider Demographics
NPI:1528774940
Name:NAVA, NIA NICOLE (OD)
Entity type:Individual
Prefix:DR
First Name:NIA
Middle Name:NICOLE
Last Name:NAVA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3918 INVIERNO
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-3817
Mailing Address - Country:US
Mailing Address - Phone:210-378-4198
Mailing Address - Fax:
Practice Address - Street 1:3918 INVIERNO
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-3817
Practice Address - Country:US
Practice Address - Phone:210-378-4198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10691152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist