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General NPI Number Information
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NPI Number | 1447428701
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Entity Type | Organization
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Legal Business Name | JEFF WERTZ
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Dates
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Enumeration Date | 02/20/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 1001 N I-27 STE 206
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City | PLAINVIEW
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State | TX
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Zip | 79072-3903
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Country | US
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Telephone | 806-296-7175
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Fax | 806-296-0633
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Provider Business Mailing Address
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Address Line | 1001 N I-27 STE 206
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City | PLAINVIEW
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State | TX
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Zip | 79072-3903
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Country | US
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Telephone | 806-296-7175
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Fax | 806-296-0633
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Authorized Official
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Title or Position | OWNER
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Name | MR. JEFFREY WAYNE WERTZ
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Credential |
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Telephone | 806-296-7175
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 156FX1800X
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Taxonomy Name | Optician
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License Number |
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License Number State |
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