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General NPI Number Information
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NPI Number | 1114460193
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Entity Type | Individual
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Provider Name | AMY LYNNE WITTMANN O.D.
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Gender | Female
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Dates
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Enumeration Date | 11/23/2016
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Last Update Date | 07/08/2025
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Provider Practice Location Address
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Address Line | 12236 MONTANA AVE
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City | EL PASO
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State | TX
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Zip | 79938-4851
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Country | US
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Telephone | 915-213-3410
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Fax | 915-226-0510
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Provider Business Mailing Address
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Address Line | 6217 SYLVANIA WAY
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City | EL PASO
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State | TX
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Zip | 79912-4926
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Country | US
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Telephone | 915-526-7418
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9125TG
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License Number State | TX
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