EYELID INSTITUTE, P.A.
Osteopathic Medicine at College Blvd, San Antonio, TX

License number
Texas G0814
Category
Osteopathic Medicine
Type
Pulmonary Disease
Owner
Name: DR. JORGE L. RIVERA M.D.
Title: PRESIDENT
Phone: (210) 828-8892
Address
Address
307 College Blvd, San Antonio, TX 78209
National Provider ID: 1538411962
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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THE EYELID INSTITUTE, PA

San Antonio, TX

Status:
Inactive
Registration:
Dec 19, 2001
Addresses:
307 College Blvd, San Antonio, TX 78209 (Mailing)
14615 San Pedro Ave, San Antonio, TX 78232
State ID:
0800038162
Business type:
Professional Association
Secretary, Director, Member, Presidents:
Martha C. Wilson President , Director , Member, inactive,Jorge L. Rivera Secretary, Director, Member, President, inactive
Agent:
Jorge L Rivera,307 College Blvd, San Antonio, TX 78209 (Physical)
TIN:
12600197268

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