MEDICARE: SHERRI J BRICE OD PA

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	4232TG	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	20TT	OTHER	TX	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1336458793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SHERRI J BRICE OD PA

Provider Business Mailing Address
First Line	:	1109 ROCK PRAIRIE RD STE 300
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-8651
Country	:	US
Telephone Number	:	979-764-0669
Fax Number	:	979-694-1940

Provider Business Practice Location Address
First Line	:	1109 ROCK PRAIRIE RD STE 300
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-8651
Country	:	US
Telephone Number	:	979-764-0669
Fax Number	:	979-694-1940

Authorized Official
Title or Position	:	DOCTOR
Name	:	SHERRI J BRICE
Credential	:	OD PA
Telephone Number	:	979-764-0669

Provider Enumeration Date	:	10/04/2010
Last Update Date	:	03/31/2016

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