| NPI | 1417973280 |
|---|---|
| Doing Business As | TEXAS STATE OPTICAL OF VICTORIA |
| Entity Type | Organization |
| Authorized Contact | LOREN C WAKHAM Owner 361-578-2904 |
| Organization Subpart ? | No |
| Primary Taxonomy | 152W00000X Optometrist (Licence: TX 3433T) |
| Enumeration Date | 2006-07-14 |
| Last Update Date | 2013-07-03 |