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General NPI Number Information
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NPI Number | 1558716191
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Entity Type | Individual
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Provider Name | DR. CHELSEA RENEE WAHL
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Gender | Female
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 11/21/2024
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Provider Practice Location Address
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Address Line | 11500 BEE CAVES RD STE 100
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City | AUSTIN
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State | TX
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Zip | 78738-5545
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Country | US
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Telephone | 512-494-5350
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Fax |
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Provider Business Mailing Address
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Address Line | 11500 BEE CAVES RD STE 100
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City | AUSTIN
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State | TX
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Zip | 78738-5545
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Country | US
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Telephone | 228-216-9103
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Fax |
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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 | 3319
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 9708T
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License Number State | TX
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