Provider Demographics
NPI:1649906751
Name:BRIONES, JOSE GUADALUPE (OPTICIAN)
Entity type:Individual
Prefix:
First Name:JOSE
Middle Name:GUADALUPE
Last Name:BRIONES
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 W CANTU RD STE E
Mailing Address - Street 2:
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-3093
Mailing Address - Country:US
Mailing Address - Phone:830-422-2583
Mailing Address - Fax:
Practice Address - Street 1:401 W CANTU RD STE E
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-3093
Practice Address - Country:US
Practice Address - Phone:830-422-2583
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-29
Last Update Date:2022-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician