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Individual

DR. CLARENCE LOUIS WIDMANN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
533 WESTVIEW VLG, WACO, TX 76710-5234
(254) 776-3937
(254) 776-6810
Mailing address
533 WESTVIEW VLG, WACO, TX 76710-5234
(254) 776-3937
(254) 776-6810

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3751TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
093402802
TX
Enumeration date
08/12/2006
Last updated
07/08/2007
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