Provider Demographics
NPI:1386826329
Name:NICOLE S. BRASSELL O.D. P. C.
Entity Type:Organization
Organization Name:NICOLE S. BRASSELL O.D. P. C.
Other - Org Name:BRASSELL EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:S
Authorized Official - Last Name:BRASSELL
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:281-251-8133
Mailing Address - Street 1:10130 LOUETTA RD
Mailing Address - Street 2:STE. B
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-2116
Mailing Address - Country:US
Mailing Address - Phone:281-251-8133
Mailing Address - Fax:281-251-8139
Practice Address - Street 1:10130 LOUETTA RD
Practice Address - Street 2:STE. B
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-2116
Practice Address - Country:US
Practice Address - Phone:281-251-8133
Practice Address - Fax:281-251-8139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-01
Last Update Date:2008-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5713TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty