Organization
DIVINE INNOVATIONS PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY SETTERBERG (OWNER/MANAGER)
(361) 854-1460
Entity
Organization
Contact information
Practice address
6646 S STAPLES ST STE 108, CORPUS CHRISTI, TX 78413-5426
(361) 854-1460
Mailing address
6537 S STAPLES ST, SUITE 125 #442, CORPUS CHRISTI, TX 78413-5418
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8519
TX
152WC0802X
Corneal and Contact Management Optometrist
8519
TX
332H00000X
Eyewear Supplier
8519
TX
Other
Enumeration date
11/17/2016
Last updated
03/23/2017
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