Provider Demographics
NPI:1477254142
Name:DRS ETHRIDGE & HARDING, OPTOMETRIST PLLC
Entity Type:Organization
Organization Name:DRS ETHRIDGE & HARDING, OPTOMETRIST PLLC
Other - Org Name:DRS ETHRIDGE & HARDING, OPTOMETRIST PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:RANDAL
Authorized Official - Last Name:ETHRIDGE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:325-643-5511
Mailing Address - Street 1:1200 AUSTIN AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-3311
Mailing Address - Country:US
Mailing Address - Phone:325-643-5511
Mailing Address - Fax:325-600-4225
Practice Address - Street 1:1200 AUSTIN AVE
Practice Address - Street 2:
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-3311
Practice Address - Country:US
Practice Address - Phone:325-643-5511
Practice Address - Fax:325-600-4225
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-10
Last Update Date:2024-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty