Provider Demographics
NPI:1851730931
Name:BRAND, ANTHONY T (OD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:T
Last Name:BRAND
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 1:6575 W 119TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209-2001
Mailing Address - Country:US
Mailing Address - Phone:913-696-0092
Mailing Address - Fax:913-696-0095
Practice Address - Street 1:6575 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-2001
Practice Address - Country:US
Practice Address - Phone:913-696-0092
Practice Address - Fax:913-696-0095
Is Sole Proprietor?:No
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1964152W00000X
MO2013017318152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist