Individual
DR. JAMES WACHTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
194 CLARKSON RD, ELLISVILLE, MO 63011
(636) 227-2020
(636) 227-9968
Mailing address
PO BOX 207158, DALLAS, TX 75320-7158
(636) 200-4393
(636) 938-2650
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T03019
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
313710733
—
MO
01
—
410034998
RAILROAD MEDICARE
MO
Enumeration date
06/23/2005
Last updated
07/17/2018
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