Provider Demographics
NPI:1992699193
Name:ANDREWS, BRAZIL KATRIANA (OD)
Entity type:Individual
Prefix:
First Name:BRAZIL
Middle Name:KATRIANA
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5049 VALLEY VIEW BLVD NW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24012-2074
Mailing Address - Country:US
Mailing Address - Phone:540-362-7565
Mailing Address - Fax:
Practice Address - Street 1:5049 VALLEY VIEW BLVD NW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24012-2074
Practice Address - Country:US
Practice Address - Phone:540-362-7565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618003499152WP0200X, 152WS0006X, 152WV0400X, 152W00000X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation