PBR Optometrists LTD of Windom
Organization Active NPI Optometrist · Windom, MN
NPI 1124153812 · NPPES record last updated Apr 2, 2008
Key facts
- NPI
- 1124153812
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Optometrist 152W00000X
- License
- 2062 (MN)
- Legal business name
- PBR OPTOMETRISTS LTD OF WINDOM
- Practice address
- 1006 4TH Ave
Windom, MN 56101-1440 - Phone
- (507) 831-2429
- Fax
- (507) 831-4243
- NPI assigned
- Feb 22, 2007
- Organization subpart
- No
Authorized official
- Name
- Brian D Temme, O.D.
- Title
- Owner
- Phone
- (507) 831-2429
Practitioners 1
-
Roger Dale Pabst, O.D.
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist |
152W00000X | 2062 | MN | Yes |
Addresses
Primary practice location
1006 4TH Ave
Windom, MN 56101-1440
Mailing address
1006 4TH Ave
PO Box 160
Windom, MN 56101-1440
Phone (507) 831-2429
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 48670PB | Other | MN | BLUECROSS BLUESHIELD |
| 2200203 | Other | MN | MEDICA |
| 112803 | Other | MN | UCARE MINNESOTA |
| 48677PB | Other | MN | BLUE PLUS |
| 942941013468 | Other | MN | PREFFEREDONE |
Other providers in Windom, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.