Provider Demographics
NPI:1619131174
Name:HOUSLER, BRANDAN JOSEPH
Entity Type:Individual
Prefix:DR
First Name:BRANDAN
Middle Name:JOSEPH
Last Name:HOUSLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:719 S MICHAEL RD
Mailing Address - Street 2:
Mailing Address - City:SAINT MARYS
Mailing Address - State:PA
Mailing Address - Zip Code:15857-2126
Mailing Address - Country:US
Mailing Address - Phone:814-335-5905
Mailing Address - Fax:
Practice Address - Street 1:765 JOHNSONBURG RD
Practice Address - Street 2:
Practice Address - City:SAINT MARYS
Practice Address - State:PA
Practice Address - Zip Code:15857-3417
Practice Address - Country:US
Practice Address - Phone:814-781-3435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002105152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist