Provider Demographics
NPI:1235232034
Name:WEST UNIVERSITY INTERNAL MEDICINE, P.L.L.C.
Entity Type:Organization
Organization Name:WEST UNIVERSITY INTERNAL MEDICINE, P.L.L.C.
Other - Org Name:DRS. BRADEN & BOEHME, P.L.L.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:Y
Authorized Official - Last Name:BOEHME
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-375-2904
Mailing Address - Street 1:3400 BISSONNET ST STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-2153
Mailing Address - Country:US
Mailing Address - Phone:713-662-2777
Mailing Address - Fax:713-665-6227
Practice Address - Street 1:3400 BISSONNET ST STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77005-2153
Practice Address - Country:US
Practice Address - Phone:713-662-2777
Practice Address - Fax:713-665-6227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-07
Last Update Date:2010-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX077160OtherAETNA HMO
TXDA5058OtherRAILROAD MEDICARE
TX085785601Medicaid
TXU81JMedicare ID - Type Unspecified