Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | H6077 | TX |
NPI | 1023015773 |
---|---|
Provider Name | Dr. Steven Brent Brotzman |
First Address | Austin, TX 78759-3935 |
Second Address | Austin, TX 78759-3935 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2005 |
Last Update Date | 08/03/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
82160X | BLUE CROSS BLUE SHIELD (01) | TX |
F68005 | (02) | TX |