Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | F3778 | TX |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | F3778 | TX |
N | 207XX0004X | Foot and Ankle Orthopaedic Surgeon | F3778 | TX |
N | 207XX0801X | Orthopaedic Trauma Surgeon | F3778 | TX |
NPI | 1740270206 |
---|---|
Provider Name | James W Brodsky |
First Address | Dallas, TX 75246-1615 |
Second Address | Dallas, TX 75246-1615 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2005 |
Last Update Date | 28/09/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
042842701 | (05) | TX |
042842702 | (05) | TX |
840761 | BCBS (01) | TX |
C13788 | (02) |