Ronald A. Brake,O.D.,P.A.
LBN: Ronald A. Brake,O.D.,P.A.
Ronald A. Brake,O.D.,P.A. is an health care organization with primary practice located at 611 Coliseum Dr Suite B, Winston Salem NC 27106-5310. The organization recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is the primary health care specialty.
Ronald A. Brake,O.D.,P.A. can be contacted via phone (336) 397-0768, or through Brake, Ronald Allen via phone (336) 766-6680.
Contact Information
Primary practice address
611 Coliseum Dr Suite B
Winston Salem NC 27106-5310
Phone: (336) 397-0768
Fax:
Website:
Authorized official contact:
Name: Brake, Ronald Allen Doctor of Optometry (OD)
Phone: (336) 766-6680
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 1384 | North Carolina |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | 1384 | North Carolina |
Profile Details
| NPI number | 1982093563 |
|---|---|
| LBN Legal business name | Ronald A. Brake,O.D.,P.A. |
| DBA Doing business as | |
| Authorized official | Brake, Ronald Allen Doctor of Optometry (OD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 20th, 2015 |
| Last updated | Jan 20th, 2015 - about 9 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982093563 | NPPES |
| North Carolina | MEDICAID | 1174747851 |
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