Provider Demographics
NPI:1144333980
Name:KRAMER, BRYAN L (OD)
Entity type:Individual
Prefix:DR
First Name:BRYAN
Middle Name:L
Last Name:KRAMER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:401A W COMMERCE ST
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-1701
Mailing Address - Country:US
Mailing Address - Phone:325-643-6252
Mailing Address - Fax:325-643-6252
Practice Address - Street 1:401A W COMMERCE ST
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-1701
Practice Address - Country:US
Practice Address - Phone:325-643-6252
Practice Address - Fax:325-643-6053
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5981T152W00000X
MOT03205152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13884OtherAVESIS VISION
TX019092801Medicaid
TX926596OtherBLOCK VISION
TX1323830OtherCLARITY VISION
TX00093POtherBLUE CROSS/ BLUE SHIELD
TX48044OtherDAVIS VISION
TX29133OtherSPECTERA
TX13884OtherAVESIS VISION
TX926596OtherBLOCK VISION