| Provider / Organization | NPI | Date Certified |
|---|---|---|
| GEORGE GREEN | 1477008274 | 2024-01-07 |
George Green is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1477008274. Registration indicates George Green is a provider of access to ophthalmic care services with a specialization in Eye & Vision Services Providers, Optometrist (Eye and Vision Services Providers, Optometrist) (Optometrist, ) (Vision/Audiology, ) (Optometrist, Eye and Vision Services Providers)
| Registration | PART-B:Y DME:Y HHA:Y PMD:N |
| Entity Type | Individual |
| Provider Name | George Green |
| Practice Office Address | 10003 NW MILITARY HWY STE 3111 SAN ANTONIO, TX US |
| Practice Office Telephone | 2103553551 |
| Mailing Address | PO BOX 745 BOERNE, TX 780060745 US |
| Business Telephone | 2103553551 |
| Code | Practice | License No State |
|---|---|---|
| 152W00000X PRIMARY | Access to Ophthalmic Care Eye & Vision Services Providers Optometrist Eye and Vision Services Providers Optometrist Optometrist Vision/Audiology Optometrist Eye and Vision Services Providers | 8993TG
TX |