Individual
GARRETT WENTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
4015 84TH ST, LUBBOCK, TX 79423-1913
(806) 798-2020
Mailing address
3104 INDIANA AVE, LUBBOCK, TX 79410-3148
(806) 793-1927
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
9367T
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9367T
STATE LICENSE
TX
Enumeration date
09/14/2017
Last updated
04/06/2020
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