Ann Lynne Wild, O.D.

Primary specialty

OptometristTaxonomy code 152W00000X

License

2142TG Issued in TX

Practice address

2746 Longmire Dr
College Station, TX 77845-5424

Phone

(979) 764-1554

Fax

(979) 694-2259

NPI assigned

Oct 26, 2005

Last updated

Mar 17, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dr Ann L Wild Optometrist PA

  dba Dr Ann L Wild, Optometrist

  • Optometrist
  • College Station, TX
  • NPI 1063687606
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1130284800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205712000000",
    "number": "1659361087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2746 LONGMIRE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455424",
            "telephone_number": "979-764-1554",
            "fax_number": "979-694-2259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2746 LONGMIRE DR",
            "city": "COLLEGE STATION",
            "state": "TX",
            "postal_code": "778455424",
            "telephone_number": "979-764-1554",
            "fax_number": "979-694-2259"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILD",
        "first_name": "ANN",
        "middle_name": "LYNNE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-26",
        "last_updated": "2008-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "2142TG",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• WHM Eye Associates, P.a. (Marr-Kirkland Eye Center)
• Rebekah Lynne Wiech
• Emily Elizabeth Wiegert, PT
• Capri Wiggins, LCSW
• Austin N Wilcox, LPC, LMFT
• Emily Nicole Wiley
• Kendall Mary Wilhelm-Glab
• Eric K Wilke, MD
• Erin Wilkinson, PHARM.D., RPH
• Nathan Edward Wilkinson

• Optometrist in College Station, TX
• Providers in College Station, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.