Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | L0049 | TX |
NPI | 1043270630 |
---|---|
Provider Name | Amy Cornelia Brenski |
First Address | Dallas, TX 75373-3784 |
Second Address | Frisco, TX 75033-4254 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2006 |
Last Update Date | 09/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H23261 | (02) |