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NPI Code Detail

MEDICARE: BRENDA MAIER COA

MEDICARE: BRENDA MAIER COA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1156FX1101XOphthalmic Assistant288290TX

General Provider Information

NPI Number : 1073495792
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRENDA MAIER COA
Provider Business Mailing Address
First Line : 7402 LAKE RIDGE PKWY APT 9121
Second Line :
City : GRAND PRAIRIE
State : TX
Zip : 75054-0419
Country : US
Telephone Number : 817-891-9676
Fax Number :
Provider Business Practice Location Address
First Line : 2201 SE LOOP 820
Second Line :
City : FORT WORTH
State : TX
Zip : 76119-5863
Country : US
Telephone Number : 817-730-0000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2025
Last Update Date : 07/23/2025

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Directions to “ BRENDA MAIER COA” Practice Location

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