Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | 1867 | TX |
NPI | 1053570317 |
---|---|
Provider Name | Dr. John A Brust |
First Address | Dallas, TX 75284-4658 |
Second Address | Killeen, TX 76549-4218 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2008 |
Last Update Date | 02/12/2021 |