Provider Demographics
NPI:1871696344
Name:TORRES, ANTONIO JUAN (OD)
Entity type:Individual
Prefix:DR
First Name:ANTONIO
Middle Name:JUAN
Last Name:TORRES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6852 HARRISBURG BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77011-4626
Mailing Address - Country:US
Mailing Address - Phone:713-926-6567
Mailing Address - Fax:713-926-6091
Practice Address - Street 1:6852 HARRISBURG BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77011-4626
Practice Address - Country:US
Practice Address - Phone:713-926-6567
Practice Address - Fax:713-926-6091
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5033T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU52125Medicare UPIN