Provider Demographics
NPI:1134249493
Name:POOLE, BRIANNE NEAL (OD)
Entity type:Individual
Prefix:DR
First Name:BRIANNE
Middle Name:NEAL
Last Name:POOLE
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:BRIANNE
Other - Middle Name:JEAN
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:1008 FALLS PKWY
Mailing Address - Street 2:
Mailing Address - City:MARBLE FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:78654-4630
Mailing Address - Country:US
Mailing Address - Phone:830-693-3292
Mailing Address - Fax:830-693-8365
Practice Address - Street 1:1008 FALLS PKWY
Practice Address - Street 2:
Practice Address - City:MARBLE FALLS
Practice Address - State:TX
Practice Address - Zip Code:78654-4630
Practice Address - Country:US
Practice Address - Phone:830-693-3292
Practice Address - Fax:830-693-8365
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX7093TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83379QOtherBCBSTX
MP2629864OtherDEA LICENSE
MP2629864OtherDEA LICENSE