Individual
JACKIE DIEM WANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
837 BROWN TRL, BEDFORD, TX 76022-7386
(817) 927-6400
(817) 702-6485
Mailing address
837 BROWN TRL, BEDFORD, TX 76022-7386
(817) 927-6400
(817) 702-6485
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8199T
TX
Other
Enumeration date
08/09/2013
Last updated
02/11/2016
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