Organization
BRYAN N ANGLE MD PA
Active
Other names
Angelo Retina Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN N ANGLE M.D. (OWNER)
(325) 942-9300
Entity
Organization
Contact information
Practice address
303 W HARRIS AVE, SUITE 3, SAN ANGELO, TX 76903-6377
(325) 942-9300
(325) 942-9333
Mailing address
303 W HARRIS AVE, SUITE 3, SAN ANGELO, TX 76903-6377
(325) 942-9300
(325) 942-9333
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
J1844
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100331104
—
TX
01
—
8K6102
MEDICARE PTAN
—
Enumeration date
11/18/2010
Last updated
10/30/2012
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