Individual
GREGG WENTWORTH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5788 ECKHERT RD, SAN ANTONIO, TX 78240-3900
(210) 699-2113
Mailing address
8831 FEATHER TRL, HELOTES, TX 78023-4486
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4363
TX
Other
Enumeration date
03/14/2006
Last updated
07/09/2007
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