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General NPI Number Information
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NPI Number | 1417336702
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Entity Type | Organization
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Legal Business Name | FIVE STAR EYE CARE, PLLC
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Dates
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Enumeration Date | 05/20/2015
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Last Update Date | 07/16/2015
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Provider Practice Location 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 | 830-305-1109
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Fax |
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Provider Business Mailing Address
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Address Line | 4006 MOUNT LAUREL DR
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City | SAN ANTONIO
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State | TX
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Zip | 78240-1024
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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 | PRESIDENT
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Name | DR. STEPHEN CLAY WOLFE
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Credential | O.D.
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Telephone | 830-305-1109
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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 | 7711TG
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License Number State | TX
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