DR. WILLIAM BRUCE BOURLAND (NPI# 1063413318) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063413318 |
| Entity Type | Individual |
| Full Name | DR. WILLIAM BRUCE BOURLAND |
| Credential | OD |
| Practice Address |
701 Front St Evanston WY 82930-3522 |
| Practice Telephone | 3077898820 |
| Practice Fax Number | 3077898823 |
| Mailing Telephone | 3077898820 |
| Mailing Fax Number | 3077898823 |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2010-09-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 152W00000X | Optometrist | 238 | NM | Eye and Vision Services Providers |
| Y | 152W00000X | Optometrist | 203T | WY | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AETNA | 830336991 | 01 | |
| WY | 102083800 | 05 | |
| CIGNA/MEDICARE | 4437740001 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922266287 | William Gordon Bourland II | Specialist | 7117 Forestview Dr, Arlington, TX 76016-5032 | 2008-05-22 |
| 1447202718 | William A Bourland | Surgery | 222 N 2nd St, Ste 112, Boise, ID 83702-6109 | 2006-05-16 |
| Street Address |
701 FRONT ST |
| City | EVANSTON |
| State | WY |
| Zip Code | 82930-3522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619147733 | William Bruce Bourland Od PC | Optometrist | 701 Front St, Evanston, WY 82930-3522 | 2008-03-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598398935 | Colby Kim Gomez | Physical Therapist | 190 Arrowhead Dr, Evanston, Wy 82930, Evanston, WY 82930 | 2020-02-13 |
| 1164808382 | Marilyn Carol Edgeworth Tacoma | Registered Nurse | 1037 Morse Lee St, Evanston, WY 82930 | 2015-08-11 |
| 1699159723 | Impact Physical Therapy LLC | Clinic/Center | 96 Yellow Creek Road, Evanston, WY 82930 | 2015-07-18 |
| 1578942421 | Mark Carstensen | Case Manager/Care Coordinator | 219 7th Street, Evanston, WY 82930 | 2015-05-26 |
| 1013396241 | Jennifer Carstensen | Case Manager/Care Coordinator | 325 Arrowhead Drive, Evanston, WY 82930 | 2015-05-20 |
| 1780083782 | Christa Lena Barker | Nurse Practitioner | 191 Overthrust Road, Evanston, WY 82930 | 2014-08-15 |
| 1366865339 | Don Mckay Francom | Dentist | 170 Arrowhead Dr. Suite 1, Evanston, WY 82930 | 2014-01-28 |
| 1417228370 | Premier Surgical Center, LLC | Clinic/Center | 195 Overthrust Road, Evanston, WY 82930 | 2012-01-24 |
| 1588959324 | Mejia D Williams | Social Worker | 190 Overthrust Road, Evanston, WY 82930 | 2011-06-09 |
| 1225327000 | Richard Jay Capener | Family Medicine | 196 Arrowhead Dr Ste 1, Evanston, WY 82930 | 2011-04-01 |
| Find all providers in zip 82930 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033725114 | Sabrina D'haiti | Optometrist | 607 Oakton St, Evanston, IL 60202-5615 | 2020-09-23 |
| 1629508270 | Kevin Michael Pfeiffer | Optometrist | 2914 Central St Fl 1, Evanston, IL 60201-1237 | 2017-06-15 |
| 1164623229 | Paul Robert Barnard | Optometrist | 916 Main St, Evanston, WY 82930-3441 | 2007-05-29 |
| 1518007517 | William F Atkinson | Optometrist | 547 Cheyenne Dr, Evanston, WY 82930-5302 | 2007-02-07 |
| 1336299445 | Industrial Optical Service, Inc. | Optometrist | 522 Dempster St, Evanston, IL 60202-1303 | 2007-01-11 |
| 1083788335 | Frank E Rubin | Optometrist | 1962 Dempster St, Evanston, IL 60202-1016 | 2006-11-20 |
| 1629148804 | Rachana Suresh Patel-garud | Optometrist | 811 Church St, Evanston, IL 60201-3706 | 2006-11-08 |
| 1326153032 | Sanela Puskar | Optometrist | 2000 Central St, Evanston, IL 60201-2218 | 2006-08-20 |
| 1043220783 | Gina Marie Piper | Optometrist | 522 Dempster Ave., Evanston, IL 60202 | 2006-08-08 |
| 1356350540 | Yevgeny Grinman | Optometrist | 1013 Davis St, Evanston, IL 60201-3609 | 2006-08-05 |
| Find all providers in EVANSTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.