Provider Demographics
NPI:1013550516
Name:WENTZ AND WOODRICH PLLC
Entity Type:Organization
Organization Name:WENTZ AND WOODRICH PLLC
Other - Org Name:WENTZ AND WOODRICH EYECARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO OWNER/OPTOMETRIST
Authorized Official - Prefix:
Authorized Official - First Name:GARRETT
Authorized Official - Middle Name:
Authorized Official - Last Name:WENTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-535-8030
Mailing Address - Street 1:4015 84TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-1913
Mailing Address - Country:US
Mailing Address - Phone:806-798-2020
Mailing Address - Fax:
Practice Address - Street 1:4015 84TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-1913
Practice Address - Country:US
Practice Address - Phone:806-798-2020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-28
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty