Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | L1533 | TX |
NPI | 1083787733 |
---|---|
Provider Name | Ms. Claire E Brenner |
First Address | Dallas, TX 75222-7435 |
Second Address | Garland, TX 75042-5709 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/11/2006 |
Last Update Date | 10/05/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
144155204 | (05) | TX |
8AD530 | BCBS (01) | TX |
H39412 | (02) | TX |
P00310734 | MEDICARE RAILROAD (01) | TX |