Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | T3852 | TX |
NPI | 1366792616 |
---|---|
Provider Name | Dr. Brett Picciotti |
First Address | Granbury, TX 76048-4562 |
Second Address | Granbury, TX 76048-4562 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2012 |
Last Update Date | 08/02/2022 |