Provider Demographics
NPI:1235178385
Name:BRONOWITZ, PHILIP F (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:F
Last Name:BRONOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:940 W STACY RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5215
Mailing Address - Country:US
Mailing Address - Phone:214-833-3100
Mailing Address - Fax:972-992-2428
Practice Address - Street 1:9901 ROYAL LN
Practice Address - Street 2:SUITE 106
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-1830
Practice Address - Country:US
Practice Address - Phone:214-902-0000
Practice Address - Fax:214-902-0002
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2424146D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No146D00000XEmergency Medical Service ProvidersPersonal Emergency Response Attendant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE15457Medicare UPIN
TX397265YLQLMedicare PIN