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Organization

BRONTE D BAKER OD INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. BRONTE D BAKER OD (OWNER)
(361) 358-3218
Entity
Organization

Contact information

Practice address
1209 N ST MARYS STREET, BEEVILLE, TX 78102
(361) 358-3218
(361) 358-3281
Mailing address
1209 N ST MARYS STREET, BEEVILLE, TX 78102
(361) 358-3218
(361) 358-3281

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2224TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00E98A
BLUE CROSS BLUE SHIELD OF TEXAS
TX
05
093501701
TX
01
410011275
RAILROAD MEDICARE
Enumeration date
06/06/2008
Last updated
06/06/2008
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