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General NPI Number Information
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NPI Number | 1386925923
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Entity Type | Individual
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Provider Name | STEPHEN C WOLFE OD
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Gender | Male
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Dates
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Enumeration Date | 09/08/2011
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Last Update Date | 11/30/2016
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Provider Practice Location Address
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Address Line | 15677-B SAN PEDRO AVE
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City | SAN ANTONIO
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State | TX
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Zip | 78232
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Country | US
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Telephone | 210-490-9205
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Fax | 210-490-3633
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Provider Business Mailing Address
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Address Line | 404 E MOUNTAIN ST
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City | SEGUIN
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State | TX
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Zip | 78155-5524
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Country | US
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Telephone | 210-366-1199
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Fax | 210-349-7111
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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 | 7711T
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License Number State | TX
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