Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | L2820 | TX |
Y | 2080P0210X | Pediatric Nephrologist | L2820 | TX |
NPI | 1295771020 |
---|---|
Provider Name | Michael C Braun |
First Address | Houston, TX 77216-1088 |
Second Address | Houston, TX 77030-3000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2006 |
Last Update Date | 19/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
145106401 | (05) | TX |
145106402 | CSHCN (01) | TX |
84515Y | BCBS (01) | TX |
H45195 | (02) | TX |