Healthcare Provider Details

I. General information

NPI: 1437354834
Provider Name (Legal Business Name): MCBRIDE & MCBRIDE OPTOMETRISTS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 03/19/2024
Certification Date: 03/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 GRAND AVE
BILLINGS MT
59102-2603
US

IV. Provider business mailing address

2120 GRAND AVE
BILLINGS MT
59102-2603
US

V. Phone/Fax

Practice location:
  • Phone: 406-656-7605
  • Fax: 406-656-6430
Mailing address:
  • Phone: 406-656-7605
  • Fax: 406-656-6430

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License NumberMT 505 AND MT 436
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: SHAWN LEBSOCK
Title or Position: OPTOMETRIST/OWNER
Credential: OD
Phone: 406-656-7605