MEDICARE: DR. CHARLENE L WERNER OD

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
1	152WX0102X	Occupational Vision Optometrist	4578T	TX

General Provider Information

NPI Number	:	1689667206
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLENE L WERNER OD

Provider Business Mailing Address
First Line	:	PO BOX 310845
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-7813
Country	:	US
Telephone Number	:	830-629-2570
Fax Number	:	830-629-2560

Provider Business Practice Location Address
First Line	:	110 W FAUST ST
Second Line	:
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78130-7813
Country	:	US
Telephone Number	:	830-629-2570
Fax Number	:	830-629-2560

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	07/08/2007

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