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General NPI Number Information
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NPI Number | 1568524890
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Entity Type | Organization
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Legal Business Name | JIMMY WADLEY EYE CARE PA
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Dates
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Enumeration Date | 12/14/2006
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Last Update Date | 05/27/2008
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Provider Practice Location Address
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Address Line | 262 S LEGGETT DR
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City | ABILENE
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State | TX
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Zip | 79605-1628
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Country | US
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Telephone | 325-676-2125
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Fax | 325-673-8160
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Provider Business Mailing Address
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Address Line | 262 S LEGGETT DR
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City | ABILENE
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State | TX
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Zip | 79605-1628
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Country | US
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Telephone | 325-676-2125
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Fax | 325-673-8160
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JAMES WESLEY WADLEY
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Credential | O.D.
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Telephone | 325-676-2125
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 2767T
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License Number State | TX
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