Kent Wise Od PA

NPI #1740319920 in Burleson, Texas

Provider Information

NPI Number: 1740319920
Entity Type: Organization
Organization Name: Kent Wise Od PA
Primary Specialty: Optometrist
Enumeration Date: Mar 5, 2007
Last Updated: Feb 6, 2009

Practice Location

Address: 1169 N BURLESON BLVD
Address 2: SUITE 131
City: Burleson
State: Texas
ZIP Code: 76028
Phone: (817) 426-6060

Authorized Official

Name: KENT B WISE, OD
Title: OD PRESIDENT
Phone: (817) 426-6060

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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