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L. BROCK WREN OD PLLC NPI 1114220936


NPI Information

NPI: 1114220936
Provider Name: L. BROCK WREN OD PLLC
Classification: Optometrist - 152W00000X
Entity Type: Organization
Address:
350 N MILWAUKEE ST
STE 1188
BOISE, ID
ZIP 83704
Phone: (208) 376-0893
Get Directions

L. BROCK WREN OD PLLC is an optometrist in Boise, ID. The provider is doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. L. BROCK WREN OD PLLC NPI is 1114220936. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

350 N MILWAUKEE ST
STE 1188
BOISE, ID
ZIP 83704-123
Phone: (208) 376-0893
Fax: (208) 376-3029

The provider's authorized official is Lee Brock Wren .
The authorized official title is Owner and has the following contact phone number (208) 376-0893.

The enumeration date for this NPI number is 12/16/2010 and was last updated on 12/16/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1152W00000XOptometristODP-100148IDAHOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1808643800MEDICAIDIDAHO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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