Brazos Prof. Opt.

NPI #1104093335 in Bryan, Texas

Provider Information

NPI Number
1104093335
Entity Type
Organization
Organization Name
Brazos Prof. Opt.
Primary Specialty
Technician/Technologist - Optician
Enumeration Date
May 15, 2008
Last Updated
Jul 29, 2008

Practice Location

Address
2901 E 29TH ST STE 105
City
Bryan
State
Texas
ZIP Code
77802-2691
Phone
(979) 776-7111

Authorized Official

Name
MR. LESTER A PROVE
Title
OWNER
Phone
(979) 776-7111

Specialties & Taxonomy Codes

Specialty
Technician/Technologist - OpticianOptician

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