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NPI Code Detail

MEDICARE: DR. KARL L WEDEL O.D.

MEDICARE: DR. KARL L WEDEL O.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1152W00000XOptometrist1964TGTX
2152W00000XOptometrist1964TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
180182QOTHERTXBLUE CROSS BLUE SHIELD
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
320729OTHERTXOPTICARE

General Provider Information

NPI Number : 1235137811
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KARL L WEDEL O.D.
Provider Business Mailing Address
First Line : 839 N NOLAN RIVER RD
Second Line :
City : CLEBURNE
State : TX
Zip : 76033-7001
Country : US
Telephone Number : 817-645-2411
Fax Number : 817-645-3447
Provider Business Practice Location Address
First Line : 839 N NOLAN RIVER RD
Second Line :
City : CLEBURNE
State : TX
Zip : 76033-7001
Country : US
Telephone Number : 817-645-2411
Fax Number : 817-645-3447
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/08/2005
Last Update Date : 02/16/2024

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