Organization
BRANDON BLAKER O D P C
Active
Other names
HILL COUNTRY VISION CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
BRANDON J BLAKER O.D. (PRESIDENT)
(830) 997-2504
Entity
Organization
Contact information
Practice address
508 S ADAMS ST, FREDERICKSBURG, TX 78624-4437
(830) 997-2504
(830) 997-5155
Mailing address
205 B WEST WATER ST, KERRVILLE, TX 78028
(830) 896-4044
(830) 257-6419
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
TX6429TG
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1952441503
—
TX
Enumeration date
02/06/2007
Last updated
01/06/2016
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