Provider Demographics
NPI:1598840449
Name:ALBRIGHT, DOUGLAS BENJAMIN (OD)
Entity Type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:BENJAMIN
Last Name:ALBRIGHT
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 1:1595 E COMMON ST.
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3154
Mailing Address - Country:US
Mailing Address - Phone:830-629-4090
Mailing Address - Fax:830-629-4089
Practice Address - Street 1:1595 E COMMON ST.
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3154
Practice Address - Country:US
Practice Address - Phone:830-629-4090
Practice Address - Fax:830-629-4089
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5550TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00E63ZOtherBLUE CROSS BLUE SHIELD
TX900015843OtherTAX ID
TX5902648OtherAETNA PPO
TX2156611OtherAETNA HMO
TX5902648OtherAETNA PPO