Provider Demographics
NPI:1639178155
Name:HARPER, BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:HARPER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 352
Mailing Address - Street 2:
Mailing Address - City:ROCKDALE
Mailing Address - State:TX
Mailing Address - Zip Code:76567-0352
Mailing Address - Country:US
Mailing Address - Phone:512-446-5599
Mailing Address - Fax:512-446-0105
Practice Address - Street 1:502 N CROCKETT AVE
Practice Address - Street 2:
Practice Address - City:CAMERON
Practice Address - State:TX
Practice Address - Zip Code:76520-2546
Practice Address - Country:US
Practice Address - Phone:254-697-4479
Practice Address - Fax:254-697-8331
Is Sole Proprietor?:No
Enumeration Date:2005-07-18
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8537207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00CU75Medicare PIN
TXC16618Medicare UPIN