Kent Wise OD PA

Primary specialty

OptometristTaxonomy code 152W00000X

License

TX4896 Issued in TX

Legal business name

KENT WISE OD PA

Practice address

1169 N Burleson Blvd
Suite 131
Burleson, TX 76028

Phone

(817) 426-6060

Fax

(817) 426-2978

NPI assigned

Mar 5, 2007

Organization subpart

No

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

Authorized official

Name

Kent B Wise, OD

Title

OD President

Phone

(817) 426-6060

Specialties & licenses 2

Addresses

Other names 1

• Vision City Doing business as

Locations

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233878400000",
    "number": "1740319920",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1169 N BURLESON BLVD",
            "address_2": "SUITE 131",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "76028",
            "telephone_number": "817-426-6060",
            "fax_number": "817-426-2978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1169 N BURLESON BLVD",
            "address_2": "SUITE 131",
            "city": "BURLESON",
            "state": "TX",
            "postal_code": "76028",
            "telephone_number": "817-426-6060",
            "fax_number": "817-426-2978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KENT WISE OD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-05",
        "last_updated": "2009-02-06",
        "status": "A",
        "authorized_official_last_name": "WISE",
        "authorized_official_first_name": "KENT",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OD PRESIDENT",
        "authorized_official_telephone_number": "817-426-6060",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Optometrist",
            "state": "TX",
            "license": "TX4896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Vision City",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Keith Anderson Orthodontics PLLC
• Ariel E Kellam, M.ED., BCBA
• James Edward Kellam
• Kristie Kendrick
• Kenneth F. Eckert
• Keshavjivandas Syp, PLLC
• Keshavjivandas Syp, PLLC
• Khalid Bazir MD PA
• Madeline Kiger, PNP
• Jennifer Dawn Kincaid, LCSW

• Optometrist in Burleson, TX
• Providers in Burleson, TX by specialty
• Optometrist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2009; 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.