Provider Demographics
NPI:1467844779
Name:BETTEN, BRADY (O D)
Entity Type:Individual
Prefix:DR
First Name:BRADY
Middle Name:
Last Name:BETTEN
Suffix:
Gender:M
Credentials:O D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 NICHOLAS ST
Mailing Address - Street 2:STE 250
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-2261
Mailing Address - Country:US
Mailing Address - Phone:402-493-6500
Mailing Address - Fax:402-493-4370
Practice Address - Street 1:9900 NICHOLAS ST STE 250
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-2261
Practice Address - Country:US
Practice Address - Phone:402-493-6500
Practice Address - Fax:402-493-4370
Is Sole Proprietor?:No
Enumeration Date:2015-02-23
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE1415152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist