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General NPI Number Information
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NPI Number | 1710259718
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Entity Type | Organization
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Legal Business Name | WIGGINS EYE CENTER, PLLC
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Dates
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Enumeration Date | 02/07/2012
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Last Update Date | 02/07/2012
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Provider Practice Location Address
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Address Line | 1727 GALLERIA OAKS
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City | TEXARKANA
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State | TX
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Zip | 75503
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Country | US
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Telephone | 318-840-1694
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Fax |
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Provider Business Mailing Address
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Address Line | 2823 OLIVE ST
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City | TEXARKANA
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State | TX
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Zip | 75503-4116
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Country | US
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Telephone | 318-840-1694
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Fax |
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Authorized Official
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Title or Position | SOLE MEMBER
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Name | DR. JOSHUA THOMAS WIGGINS
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Credential | M.D., J.D.
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Telephone | 318-840-1694
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD.203161
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License Number State | LA
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