Individual
DR. BRANDON BLAKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
205-B WEST WATER ST., KERRVILLE, TX 78028
(830) 896-4044
(830) 257-6419
Mailing address
205-B WEST WATER ST., KERRVILLE, TX 78028
(830) 896-4044
(830) 257-6419
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6429TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160081902
—
TX
01
—
32624
CHIPS/COMMFIRST
TX
01
—
32648
CHIPS/STAR
TX
01
—
80598Q
BCBS
TX
01
—
P00121646
RAILROAD MEDICARE
TX
01
—
TX6429
EYEMED
TX
Enumeration date
11/06/2006
Last updated
07/08/2007
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