Doctor Name: | MR. BRYAN DALE HUSKEY |
NPI Number: | 1083747919 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | OPTICIAN |
License Number: | DR2960 |
Business Practice Address: | 706 9th St N Texas City, TX - 775907451 |
Business Phone Number: | 4099483583 |
Business Fax Number: | 4099483583 |
Mailing Address: | 706 9th St N, TEXAS CITY |
State: | TX |
Postal Code: | 775907451 |
Phone Number: | 4099483583 |
Fax Number: | 4099483583 |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 02/25/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 156FX1800X |
License Number: | DR2960 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Eye and Vision Services Providers |
Taxonomy Classification: | Technician/Technologist |
Taxonomy Specialization: | Optician |
Taxonomy Definition: |