Healthcare Provider Details

I. General information

NPI: 1770551061
Provider Name (Legal Business Name): BRAD L STEGER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 08/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 W 6TH ST SUITE 319
BORGER TX
79007-4163
US

IV. Provider business mailing address

PO BOX 485
BORGER TX
79008-0485
US

V. Phone/Fax

Practice location:
  • Phone: 806-274-2015
  • Fax: 806-274-9770
Mailing address:
  • Phone: 806-274-2015
  • Fax: 806-274-9770

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number02528TG
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: