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General NPI Number Information
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NPI Number | 1386812246
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Entity Type | Organization
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Legal Business Name | COMOLLI & ETHRIDGE
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Dates
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Enumeration Date | 02/13/2008
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Last Update Date | 01/22/2009
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Provider Practice Location Address
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Address Line | 1200 AUSTIN AVE
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City | BROWNWOOD
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State | TX
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Zip | 76801-3311
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Country | US
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Telephone | 325-643-5511
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Fax | 325-646-1496
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Provider Business Mailing Address
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Address Line | 1200 AUSTIN AVE
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City | BROWNWOOD
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State | TX
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Zip | 76801-3311
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Country | US
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Telephone | 325-643-5511
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Fax | 325-646-1496
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Authorized Official
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Title or Position | PARTNER
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Name | DR. JAMES RANDAL ETHRIDGE
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Credential | OD
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Telephone | 325-643-5511
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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