Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | J0922 | TX |
NPI | 1033278833 |
---|---|
Provider Name | Allan R Brasier |
First Address | Galveston, TX 77555-5302 |
Second Address | Galveston, TX 77555-5302 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/12/2006 |
Last Update Date | 05/01/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
119084502 | (05) | TX |
F26008 | (02) | TX |