Organization
WOLFLIN VISION CLINIC, L.L.P.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK A. LATTA O.D. (OWNER/PARTNER)
(806) 358-2205
Entity
Organization
Contact information
Practice address
2481 I-40 WEST, AMARILLO, TX 79109-1852
(806) 358-2205
(806) 463-2907
Mailing address
2481 I-40 WEST, AMARILLO, TX 79109-1852
(806) 358-2205
(806) 463-2907
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T67Z
ALL OTHER PLANS
TX
Enumeration date
10/19/2005
Last updated
10/27/2008
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