Provider Demographics
NPI:1982600474
Name:BRUMBELOW, ROBERT EARL (OD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:EARL
Last Name:BRUMBELOW
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 1:2 FINANCIAL PLZ
Mailing Address - Street 2:STE 801
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77340-3500
Mailing Address - Country:US
Mailing Address - Phone:936-295-2020
Mailing Address - Fax:936-295-4171
Practice Address - Street 1:2 FINANCIAL PLZ
Practice Address - Street 2:STE 801
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77340-3500
Practice Address - Country:US
Practice Address - Phone:936-295-2020
Practice Address - Fax:936-295-4171
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX5228TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX102492903Medicaid
5110554OtherAETNA
910632OtherBLOCK VISION
TX80834QOtherBC
918843OtherEYEMED
TX102492903Medicaid
P00038337Medicare PIN
TXU62006Medicare UPIN
TX8A7664Medicare ID - Type Unspecified