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Individual

DR. BRAD E HANSTAD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
5044 TENNYSON PKWY STE B, PLANO, TX 75024-2953
(972) 378-4104
(972) 378-9094
Mailing address
5044 TENNYSON PKWY, STE B, PLANO, TX 75024-2953
(972) 378-4104
(972) 378-9094

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
7943T
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
800558
BLUE CROSS VISION
ND
Enumeration date
01/19/2006
Last updated
06/19/2019
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