Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | M8557 | TX |
N | 207YP0228X | Pediatric Otolaryngology | M8557 | TX |
NPI | 1003010703 |
---|---|
Provider Name | Dr. Mace Benjamin Brindley |
First Address | Waco, TX 76710-5592 |
Second Address | Waco, TX 76710-5592 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2007 |
Last Update Date | 20/11/2020 |