Provider Demographics
NPI:1699480764
Name:ENHANCE VISION CARE PLLC
Entity type:Organization
Organization Name:ENHANCE VISION CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:J
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-387-8654
Mailing Address - Street 1:6301 NW LOOP 410 STE 21A
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-3852
Mailing Address - Country:US
Mailing Address - Phone:210-680-6097
Mailing Address - Fax:210-509-4749
Practice Address - Street 1:6301 NW LOOP 410 STE 21A
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-3852
Practice Address - Country:US
Practice Address - Phone:210-680-6097
Practice Address - Fax:210-509-4749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-23
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty