Provider Demographics
NPI:1205936226
Name:CAVE, DENNIS BRYAN (OD)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:BRYAN
Last Name:CAVE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:BRYAN
Other - Middle Name:
Other - Last Name:CAVE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:303 37TH STREET
Mailing Address - Street 2:
Mailing Address - City:SNYDER
Mailing Address - State:TX
Mailing Address - Zip Code:79549
Mailing Address - Country:US
Mailing Address - Phone:325-574-2020
Mailing Address - Fax:325-573-6868
Practice Address - Street 1:303 37TH STREET
Practice Address - Street 2:
Practice Address - City:SNYDER
Practice Address - State:TX
Practice Address - Zip Code:79549
Practice Address - Country:US
Practice Address - Phone:325-574-2020
Practice Address - Fax:325-573-6868
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX03325T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX110055102OtherFIRST CARE
TXBC/BS OF TXOther00E50A
TX11390OtherCHIPS
TX093269102Medicaid
TX752258100OtherTAX ID
TX752258100OtherTAX ID
TX0256840001Medicare NSC
TXT12586Medicare UPIN
TX11390OtherCHIPS