Provider Demographics
NPI:1083787733
Name:BRENNER, CLAIRE E (MD)
Entity Type:Individual
Prefix:MS
First Name:CLAIRE
Middle Name:E
Last Name:BRENNER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:2241 PEGGY LN STE E
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-5709
Mailing Address - Country:US
Mailing Address - Phone:972-491-1155
Mailing Address - Fax:972-494-6572
Practice Address - Street 1:2241 PEGGY LN STE E
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5709
Practice Address - Country:US
Practice Address - Phone:972-494-1155
Practice Address - Fax:972-494-6572
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL1533207RI0200X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144155204Medicaid
TX8AD530OtherBCBS
TXP00310734OtherMEDICARE RAILROAD
TXP00310734OtherMEDICARE RAILROAD
TXH39412Medicare UPIN