Provider Demographics
NPI:1437531381
Name:OSTERMAN, NATHAN EVAN (OD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:EVAN
Last Name:OSTERMAN
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 1:586 5TH ST
Mailing Address - Street 2:STE 300
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-9720
Mailing Address - Country:US
Mailing Address - Phone:541-469-7775
Mailing Address - Fax:
Practice Address - Street 1:11901 W PARMER LN STE 400
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7655
Practice Address - Country:US
Practice Address - Phone:512-528-1144
Practice Address - Fax:512-528-1143
Is Sole Proprietor?:No
Enumeration Date:2015-06-26
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901004909152W00000X
TX9443TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist