Wakham, Loren C

Wakham, Loren C is an individual health care provider with primary practice located at 505 E Mockingbird Ln , Victoria TX 77904-2043. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Wakham, Loren C can be contacted via phone (361) 578-2904.

Contact Information

Primary practice address
505 E Mockingbird Ln Victoria TX 77904-2043
Fax: (361) 578-7931
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 3433T Texas

Profile Details

NPI number 1275683104
LBN Legal business name Wakham, Loren C
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 11th, 2007
Last updated Mar 27th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275683104 NPPES
Texas MEDICAID 037012401

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