Organization
RUSSELL E SWANN M.D. PA
Active
Other names
BRAZOS EYE SURGERY OF TEXAS
Organization subpart
No
Provider details
NPI number
Authorized official
SHAYE J WOOTEN (INSURANCE BILLING)
(254) 772-4499
Entity
Organization
Contact information
Practice address
201 LONDONDERRY DR, WACO, TX 76712-7902
(254) 772-4499
(254) 772-4436
Mailing address
201 LONDONDERRY DR, WACO, TX 76712-7902
(254) 772-4499
(254) 772-4436
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
E5626
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
085656902
—
TX
01
—
1073518072
NPI
TX
01
—
1477717759
NPI
TX
01
—
1619130895
NPI
TX
01
—
1841293016
NPI
—
01
—
DC9834
RR MEDICARE PIN
TX
Enumeration date
12/05/2007
Last updated
10/23/2012
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