Texas State Optical of Brenham

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

2133T Issued in TX

Legal business name

TEXAS STATE OPTICAL OF BRENHAM

Practice address

2648 Highway 36 S
Brenham, TX 77833-9600

Phone

(979) 836-1166

Fax

(979) 830-1573

NPI assigned

Oct 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Donald Eugene Rexroad, O.D.

Title

President/Optometrist

Phone

(979) 836-1077

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1386729903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2648 HIGHWAY 36 S",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778339600",
            "telephone_number": "979-836-1166",
            "fax_number": "979-830-1573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2648 HIGHWAY 36 S",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778339600",
            "telephone_number": "979-836-1166",
            "fax_number": "979-830-1573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TEXAS STATE OPTICAL OF BRENHAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REXROAD",
        "authorized_official_first_name": "DONALD",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "PRESIDENT/OPTOMETRIST",
        "authorized_official_telephone_number": "979-836-1077",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "O.D."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "TX",
            "license": "2133T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.