Individual provider · Type 1 NPI
Fidel Alexander Pantoja, OPTICIAN
Eyewear Supplier · San Antonio, TX
NPI number
1124783881
Active
Practice location
1431 W Winnipeg Ave
San Antonio, TX 78225-2244
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optician | 156FX1800X | 192472 (TX) |
| Eyewear Supplier Primary | 332H00000X | 192472 (TX) |
Eyewear Supplier: An organization that provides spectacles, contact lenses, and other vision enhancement devices prescribed by an optometrist or ophthalmologist.
About NPI 1124783881
Fidel Alexander Pantoja, OPTICIAN's National Provider Identifier is 1124783881, issued on Nov 7, 2021. The primary taxonomy on file is Eyewear Supplier (332H00000X), and the practice location is in San Antonio, TX. The record was last updated on Nov 23, 2021.