Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | N5585 | TX |
NPI | 1265516132 |
---|---|
Provider Name | Dr. Julienne Brackett |
First Address | Houston, TX 77030-2303 |
Second Address | Houston, TX 77030-2303 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 13/07/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
211291401 | (05) | TX |
211291402 | CSHCN (01) | TX |