Individual
DR. CLINTON M DEWOLFE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
901-C HIGHWAY 80, SAN MARCOS, TX 78666
(512) 353-3310
Mailing address
901-C HIGHWAY 80, SAN MARCOS, TX 78666
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
01442
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80521Q
BLUE CROSS BLUE SHIELD ID
TX
Enumeration date
08/16/2006
Last updated
07/08/2007
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