Provider Demographics
NPI:1801993555
Name:WENDLER, CARLA A (OD)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:A
Last Name:WENDLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2448 MISSOURI AVE
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88001-5109
Mailing Address - Country:US
Mailing Address - Phone:575-521-1050
Mailing Address - Fax:
Practice Address - Street 1:2448 MISSOURI AVE
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-5109
Practice Address - Country:US
Practice Address - Phone:575-523-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-17
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2992152W00000X
NM668152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist