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General NPI Number Information
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NPI Number | 1609270016
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Entity Type | Individual
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Provider Name | BRIAN RATCLIFF OD
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Gender | Male
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Dates
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Enumeration Date | 10/14/2014
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Last Update Date | 10/14/2014
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Provider Practice Location Address
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Address Line | 1205 HIGHWAY 327 E
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City | SILSBEE
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State | TX
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Zip | 77656-6007
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Country | US
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Telephone | 409-385-2811
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Fax |
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Provider Business Mailing Address
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Address Line | 115 MAGNOLIA TRL
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City | LUMBERTON
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State | TX
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Zip | 77657-9276
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Country | US
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Telephone | 801-592-0495
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 8550T
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License Number State | TX
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