Provider Demographics
NPI:1558653121
Name:NATALIE R. WIGGINS, OD, PLLC
Entity Type:Organization
Organization Name:NATALIE R. WIGGINS, OD, PLLC
Other - Org Name:TWO RIVERS EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPTOMETRIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:RENEE
Authorized Official - Last Name:WIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:830-620-6005
Mailing Address - Street 1:1659 W STATE HIGHWAY 46
Mailing Address - Street 2:120
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78132-4744
Mailing Address - Country:US
Mailing Address - Phone:830-620-6005
Mailing Address - Fax:
Practice Address - Street 1:1659 W STATE HIGHWAY 46 STE 120
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78132-4745
Practice Address - Country:US
Practice Address - Phone:830-620-6005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2012-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7267TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty