Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
BRANDON RAY LA FUENTE, BCO, BADO
Active Sole ProprietorOcularist · EDMOND, OK
Registration Details
- NPI Number
- 1316300163
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 30, 2016 (10.064538301375 yrs)
- Last Updated
- Apr 27, 2017
- Sole Proprietor
- Yes
Practice Information
- Address
-
2104 BANDIT PTEDMOND, OK, 730252832Browse OK providers · Browse ZIP 73025
- Phone
- 4056202543
- Primary Specialty
-
Ocularist
156FX1700X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.