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Contact Information

KENT WISE OD PA
1169 N BURLESON BLVD
SUITE 131
BURLESON, TX76028
 Phone: 817-426-6060
 Fax: 817-426-2978
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for KENT WISE OD PA

NPI Number 1740319920
LBN Legal business name KENT WISE OD PA
Authorized official KENT WISE - (OD PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 03/05/2007
Last updated 02/06/2009 - About 17 years ago
Identifiers
TX License # TX4896
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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