Individual
DR. LARRY WILKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O. D.
Contact information
Practice address
4000 AVENUE I, ROSENBERG, TX 77471-3904
(281) 342-4664
(281) 232-0894
Mailing address
4000 AVENUE I, P O BOX 607, ROSENBERG, TX 77471-3904
(281) 342-4664
(281) 232-0894
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
02165T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
019274201
—
TX
05
—
093539701
—
TX
Enumeration date
09/28/2005
Last updated
08/21/2013
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