Provider Demographics
NPI:1366921702
Name:OCULAR PROSTHETIC DESIGNS, LLC
Entity type:Organization
Organization Name:OCULAR PROSTHETIC DESIGNS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OCULARIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:BRINKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:BCO, BADO
Authorized Official - Phone:254-410-7061
Mailing Address - Street 1:1120 S 31ST ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-5215
Mailing Address - Country:US
Mailing Address - Phone:254-410-7061
Mailing Address - Fax:254-410-7062
Practice Address - Street 1:1120 S 31ST ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504-5215
Practice Address - Country:US
Practice Address - Phone:254-721-3196
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes335E00000XSuppliersProsthetic/Orthotic Supplier