Provider Demographics
NPI:1023015773
Name:BROTZMAN, STEVEN BRENT (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:BRENT
Last Name:BROTZMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11652 JOLLYVILLE RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-3935
Mailing Address - Country:US
Mailing Address - Phone:512-977-0000
Mailing Address - Fax:512-977-0020
Practice Address - Street 1:11652 JOLLYVILLE RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-3935
Practice Address - Country:US
Practice Address - Phone:512-977-0000
Practice Address - Fax:512-977-0020
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH6077174400000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX82160XOtherBLUE CROSS BLUE SHIELD
TXF68005Medicare UPIN
TX82160XOtherBLUE CROSS BLUE SHIELD