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General NPI Number Information
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NPI Number | 1396193918
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Entity Type | Organization
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Legal Business Name | WILDCAT VISION PLLC
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Dates
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Enumeration Date | 05/25/2016
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Last Update Date | 05/25/2016
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Provider Practice Location Address
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Address Line | 2000 US HIGHWAY 181
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City | PORTLAND
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State | TX
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Zip | 78374-4172
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Country | US
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Telephone | 361-643-5353
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Fax |
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Provider Business Mailing Address
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Address Line | 913 LOUIS LYNCH DR
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City | CORPUS CHRISTI
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State | TX
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Zip | 78408-2631
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CHRISTINE M AGUILAR
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Credential | O.D.
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Telephone | 832-359-8669
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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 | 6521T
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License Number State | TX
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