Provider Demographics
NPI:1770129827
Name:BRAZOS EYE CARE LLC
Entity type:Organization
Organization Name:BRAZOS EYE CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OD
Authorized Official - Prefix:
Authorized Official - First Name:KAYLA
Authorized Official - Middle Name:
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:979-480-0815
Mailing Address - Street 1:100 HIGHWAY 332 W STE 1242
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-4037
Mailing Address - Country:US
Mailing Address - Phone:979-480-0815
Mailing Address - Fax:979-480-0849
Practice Address - Street 1:100 HIGHWAY 332 W STE 1242
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-4037
Practice Address - Country:US
Practice Address - Phone:979-480-0815
Practice Address - Fax:979-480-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-25
Last Update Date:2019-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty