Provider Demographics
NPI:1285945519
Name:DR. MITCHEL L. WESS, PA
Entity type:Organization
Organization Name:DR. MITCHEL L. WESS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MITCHEL
Authorized Official - Middle Name:L
Authorized Official - Last Name:WESS
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:361-727-9595
Mailing Address - Street 1:2401 HIGHWAY 35 N
Mailing Address - Street 2:
Mailing Address - City:ROCKPORT
Mailing Address - State:TX
Mailing Address - Zip Code:78382-5704
Mailing Address - Country:US
Mailing Address - Phone:361-727-9595
Mailing Address - Fax:361-727-9696
Practice Address - Street 1:2401 HIGHWAY 35 N
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:TX
Practice Address - Zip Code:78382-5704
Practice Address - Country:US
Practice Address - Phone:361-727-9595
Practice Address - Fax:361-727-9696
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-01
Last Update Date:2010-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX2399TG152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact ManagementGroup - Single Specialty