Individual
JERRY BRINEGAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
6001 AIRPORT BLVD STE 2206, AUSTIN, TX 78752-4219
(512) 454-3665
(512) 454-4602
Mailing address
6001 AIRPORT BLVD STE 2206, AUSTIN, TX 78752-4219
(512) 454-3665
(512) 454-4602
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
6388
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
81239Q
BLUE CROSS BLUE SHIELD
TX
01
—
TX6388
EYEMED
TX
Enumeration date
08/04/2006
Last updated
07/08/2007
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