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General NPI Number Information
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NPI Number | 1558653121
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Entity Type | Organization
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Legal Business Name | NATALIE R. WIGGINS, OD, PLLC
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Dates
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Enumeration Date | 05/13/2011
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Last Update Date | 04/07/2012
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Provider Practice Location Address
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Address Line | 1659 W STATE HIGHWAY 46 STE 120
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City | NEW BRAUNFELS
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State | TX
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Zip | 78132-4745
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Country | US
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Telephone | 830-620-6005
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Fax |
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Provider Business Mailing Address
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Address Line | 1659 W STATE HIGHWAY 46 120
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City | NEW BRAUNFELS
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State | TX
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Zip | 78132-4744
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Country | US
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Telephone | 830-620-6005
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST/OWNER
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Name | DR. NATALIE RENEE WIGGINS
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Credential | OD
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Telephone | 830-620-6005
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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 | 7267TG
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License Number State | TX
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