Basic Information
| Provider Information | |||||||||
| NPI: | 1649260142 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ADAMS | ||||||||
| FirstName: | GEORGE | ||||||||
| MiddleName: | LEGARE | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | III | ||||||||
| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 400 DICKMAN RD | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782342604 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2102216693 | ||||||||
| FaxNumber: | 2102218360 | ||||||||
| Practice Location | |||||||||
| Address1: | 3851 ROGER BROOKE DR | ||||||||
| Address2: | BAMC/MCHE-QD/CREDENTIALS | ||||||||
| City: | FORT SAM HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782344501 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2109162460 | ||||||||
| FaxNumber: | 2109165102 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/26/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 3001T | TX | Y | Eye and Vision Services Providers | Optometrist | 152W00000X | 1637 | CO | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 7407 | CA | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 1462 | WA | N | Eye and Vision Services Providers | Optometrist |
No ID Information.