Individual
DR. LAURA ELIZABETH WIESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1138 BELT LINE RD STE 230, GARLAND, TX 75040-1994
(972) 495-3997
(972) 414-0912
Mailing address
3104 CROSS BEND RD, PLANO, TX 75023-5603
(972) 596-3429
(972) 596-3429
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5470TG
TX
Other
Enumeration date
05/03/2007
Last updated
07/08/2007
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