Individual
DANNY RUSSELL BRISTOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
11500 BEE CAVES ROAD, #100, AUSTIN, TX 78738
(512) 263-3937
(512) 263-3940
Mailing address
11500 BEE CAVES ROAD, #100, AUSTIN, TX 78738
(512) 263-3937
(512) 263-3940
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5613TG
TX
152WC0802X
Corneal and Contact Management Optometrist
5613TG
TX
152WP0200X
Pediatric Optometrist
5613TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0088FE
BCBS
TX
05
—
172729901
—
TX
Enumeration date
09/15/2006
Last updated
10/02/2008
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