Provider Demographics
NPI:1174701940
Name:ARMAND L. WILTZ, M.D., P.A.
Entity type:Organization
Organization Name:ARMAND L. WILTZ, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARMAND
Authorized Official - Middle Name:L
Authorized Official - Last Name:WILTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:432-751-1156
Mailing Address - Street 1:3411 UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79413-2438
Mailing Address - Country:US
Mailing Address - Phone:806-796-0507
Mailing Address - Fax:806-796-0507
Practice Address - Street 1:207 NW 8TH ST
Practice Address - Street 2:
Practice Address - City:SEMINOLE
Practice Address - State:TX
Practice Address - Zip Code:79360-3447
Practice Address - Country:US
Practice Address - Phone:432-758-1156
Practice Address - Fax:432-758-4740
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-04
Last Update Date:2012-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7663207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00356YMedicare PIN