Provider Demographics
NPI:1548446024
Name:BRYAN OPTICIANS
Entity type:Organization
Organization Name:BRYAN OPTICIANS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTICIAN/MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TAMMIE
Authorized Official - Middle Name:LINN
Authorized Official - Last Name:BLAHUTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-772-9971
Mailing Address - Street 1:7777 SOUTHWEST FWY
Mailing Address - Street 2:#106
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1802
Mailing Address - Country:US
Mailing Address - Phone:713-772-9971
Mailing Address - Fax:713-772-3020
Practice Address - Street 1:7777 SOUTHWEST FWY
Practice Address - Street 2:#106
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1802
Practice Address - Country:US
Practice Address - Phone:713-772-9971
Practice Address - Fax:713-772-3020
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-15
Last Update Date:2008-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0878070001Medicare NSC