Provider Demographics
NPI:1134122260
Name:YEAMAN, ROBERT BRIAN (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRIAN
Last Name:YEAMAN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:223 S MORGAN ST
Mailing Address - Street 2:
Mailing Address - City:GRANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:76048-1953
Mailing Address - Country:US
Mailing Address - Phone:817-573-7153
Mailing Address - Fax:817-573-5640
Practice Address - Street 1:223 S MORGAN ST
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-1953
Practice Address - Country:US
Practice Address - Phone:817-573-7153
Practice Address - Fax:817-573-5640
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4171TG152W00000X, 152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1686057OtherUNITED HEALTHCARE
TX5443297OtherCCN NETWORK
TXDA7004OtherRAILROAD MEDICARE
TX010794060OtherPRIVATE HEALTHCARE SYSTEM
TX80884QOtherBLUE CROSS BLUE SHIELD
TX040799103Medicaid
TX2090059OtherFIRST HEALTH NETWORK
TX010794060OtherVISION SERVICE PLAN
TX907420OtherBLOCK VISION
TX12254OtherOPTICARE
TXDA7004OtherRAILROAD MEDICARE
TX907420OtherBLOCK VISION