Provider Demographics
NPI:1891878559
Name:NEWTON, RONALD (OD)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:NEWTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 SALINAS AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78040-5751
Mailing Address - Country:US
Mailing Address - Phone:956-723-2132
Mailing Address - Fax:956-723-1721
Practice Address - Street 1:609 SALINAS AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78040-5751
Practice Address - Country:US
Practice Address - Phone:956-723-2132
Practice Address - Fax:956-723-1721
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-23
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3203-TG152W00000X
TX3203TG156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1352197-06Medicaid
TX1352197-02Medicaid
00E13RMedicare PIN
TX1352197-06Medicaid
TX1352197-02Medicaid