MEDICARE: BRIXTON OPTICIANS

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
1	152W00000X	Optometrist	2242	OK

General Provider Information

NPI Number	:	1619176310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIXTON OPTICIANS

Provider Business Mailing Address
First Line	:	8812 N COUNCIL RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-3246
Country	:	US
Telephone Number	:	405-773-3937
Fax Number	:	405-728-3939

Provider Business Practice Location Address
First Line	:	8812 N COUNCIL RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73132-3246
Country	:	US
Telephone Number	:	405-773-3937
Fax Number	:	405-728-3939

Authorized Official
Title or Position	:	OPTOMETRIST/OWNER
Name	:	DR. TRAVIS G GITTINS
Credential	:	O.D.
Telephone Number	:	405-773-3937

Provider Enumeration Date	:	07/12/2007
Last Update Date	:	06/03/2021

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Directions to “BRIXTON OPTICIANS ” Practice Location

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