Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | J2931 | TX |
Y | 111NI0900X | Internist | J2931 | TX |
N | 207RC0200X | Critical Care Medicine | J2931 | TX |
N | 207RP1001X | Pulmonary Disease | J2931 | TX |
N | 207RS0012X | Sleep Medicine | J2931 | TX |
NPI | 1003835620 |
---|---|
Provider Name | David A Brickey |
First Address | Dallas, TX 75284-1656 |
Second Address | Tyler, TX 75701-2036 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 19/03/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
164496503 | (05) | TX |
164496505 | (05) | TX |
164496506 | (05) | TX |
164496507 | (05) | TX |
75-2616977-026 | TRICARE (01) | TX |
75-2616977-042 | TRICARE (01) | TX |
75-2616977-123 | TRICARE (01) | TX |
8AK460 | BCBS INDIVIDUAL # (01) | TX |
8DC861 | BCBS (01) | TX |
H10855 | (02) | TX |
P00881732 | RAILROAD MEDICARE (01) | TX |
P01154594 | RAIL ROAD (01) | TX |