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Organization

DONALD E REXROAD OD PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DONALD REXROAD OD PC (OPTOMETRIST)
(979) 836-1077
Entity
Organization

Contact information

Practice address
2648 HIGHWAY 36 S, BRENHAM, TX 77833-9600
(979) 836-1077
(979) 830-1573
Mailing address
2648 HIGHWAY 36 S, BRENHAM, TX 77833-9600
(979) 836-1077
(979) 830-1573

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2133T
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00E84B
MEDICARE ID-TYPE UNSPECIFIED
TX
05
121655801
TX
Enumeration date
03/02/2010
Last updated
03/02/2010
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