Organization
FOREST L CALHOUN JR
Active
Other names
Wedgwood Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FOREST L CALHOUN JR. (OWNER)
(817) 292-1622
Entity
Organization
Contact information
Practice address
5709 WESTCREEK DR, FORT WORTH, TX 76133-3301
(817) 292-1622
(817) 423-2313
Mailing address
5709 WESTCREEK DR, FORT WORTH, TX 76133-3301
(817) 292-1622
(817) 423-2313
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1914483 01
—
TX
Enumeration date
10/22/2007
Last updated
07/23/2008
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