Bryan D Granger OD PC

Primary specialty

OptometristTaxonomy code 152W00000X

License

1366-535T Issued in LA

Legal business name

BRYAN D GRANGER OD PC

Practice address

1110 Angers St
New Iberia, LA 70563-2012

Phone

(337) 364-0425

Fax

(337) 364-0426

NPI assigned

Mar 19, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bryan D Granger, OD

Title

President

Phone

(337) 364-0425

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205884800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224633600000",
    "number": "1154592947",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 ANGERS ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632012",
            "telephone_number": "337-364-0425",
            "fax_number": "337-364-0426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 ANGERS ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632012",
            "telephone_number": "337-364-0425",
            "fax_number": "337-364-0426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN D GRANGER OD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-19",
        "last_updated": "2008-10-22",
        "status": "A",
        "authorized_official_last_name": "GRANGER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-364-0425",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "OD"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1366-535T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1621579",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kennell P Brown Jr., D.D.S.
• Lionel Brown
• Nicholas Brown
• Quintin Brown Christopher Cronin Brown, PHARMD
• Tiffany Brown, LPC
• Bryant Chiropractic Clinic
• Bryant Medical Group LLC
• Kaylee Bullen
• Cathleen Rhae Burgess, FNP-C
• Elson Burgess, PTA

• All providers in New Iberia, LA
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.