Individual
EDWARD PAUL BRANDENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1200 W 15TH AVE, AMARILLO, TX 79102
(806) 379-8384
(806) 379-8430
Mailing address
1200 W 15TH AVE, AMARILLO, TX 79102
(806) 379-8384
(806) 379-8430
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
TX3452TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E70F
BCBS
—
Enumeration date
09/21/2006
Last updated
07/08/2007
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