Provider Demographics
NPI:1770551061
Name:STEGER, BRAD L (OD)
Entity type:Individual
Prefix:
First Name:BRAD
Middle Name:L
Last Name:STEGER
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:PO BOX 485
Mailing Address - Street 2:
Mailing Address - City:BORGER
Mailing Address - State:TX
Mailing Address - Zip Code:79008-0485
Mailing Address - Country:US
Mailing Address - Phone:806-274-2015
Mailing Address - Fax:806-274-9770
Practice Address - Street 1:301 W 6TH ST
Practice Address - Street 2:SUITE 319
Practice Address - City:BORGER
Practice Address - State:TX
Practice Address - Zip Code:79007-4163
Practice Address - Country:US
Practice Address - Phone:806-274-2015
Practice Address - Fax:806-274-9770
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2011-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02528TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX112457003Medicaid
TX81305EOtherBCBS
TX81305EOtherBCBS
TXT16085Medicare UPIN