Individual provider · NPI-1

Dr. Clinton M Dewolfe, O.D.

Optometrist · San Marcos, TX

NPI number1720191588
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1720191588
Entity type
Individual (NPI-1)
Name
Dr. Clinton M Dewolfe
Credential
O.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 16, 2006
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist01442TXYes

Practice location

901-C Highway 80
San Marcos, TX 78666

Phone 512-353-3310

Mailing address

901-C Highway 80
San Marcos, TX 78666

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Optometrist providers in San Marcos, TX