Provider Demographics
NPI:1124919725
Name:GEORGE, BRAYDEN PATRICK
Entity type:Individual
Prefix:
First Name:BRAYDEN
Middle Name:PATRICK
Last Name:GEORGE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:302 CREEKSIDE CV
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-7684
Mailing Address - Country:US
Mailing Address - Phone:512-705-7926
Mailing Address - Fax:
Practice Address - Street 1:701 S CAPITAL OF TEXAS HWY BLDG C
Practice Address - Street 2:
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-5256
Practice Address - Country:US
Practice Address - Phone:512-705-7926
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX75805183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist