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General NPI Number Information
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NPI Number | 1952336794
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Entity Type | Individual
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Provider Name | TODD BRENTLEY LANG OD
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 01/31/2025
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Provider Practice Location Address
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Address Line | 970 KINGS HWY UNIT 2
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City | PUNTA GORDA
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State | FL
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Zip | 33980-4213
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Country | US
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Telephone | 941-637-0202
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Fax | 941-637-0425
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Provider Business Mailing Address
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Address Line | 970 KINGS HWY UNIT 2
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City | PUNTA GORDA
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State | FL
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Zip | 33980-4213
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Country | US
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Telephone | 941-637-0202
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Fax | 941-637-0425
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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 | 1141
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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 | OPC 2288
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License Number State | FL
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