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NPI Code Detail

MEDICARE: BRYAN D GRANGER OD

MEDICARE: BRYAN D GRANGER OD
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
1152W00000XOptometrist1366-535TLA

General Provider Information

NPI Number : 1497853782
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYAN D GRANGER OD
Provider Business Mailing Address
First Line : 806 JEFFERSON TER
Second Line :
City : NEW IBERIA
State : LA
Zip : 70560-5727
Country : US
Telephone Number : 337-364-0425
Fax Number : 337-364-0426
Provider Business Practice Location Address
First Line : 806 JEFFERSON TER
Second Line :
City : NEW IBERIA
State : LA
Zip : 70560-5727
Country : US
Telephone Number : 337-364-0425
Fax Number : 337-364-0426
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 03/20/2026

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Directions to “ BRYAN D GRANGER OD” Practice Location

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