Provider Demographics
NPI:1235315904
Name:BRAUN MEDICAL ASSOCIATION, PA
Entity Type:Organization
Organization Name:BRAUN MEDICAL ASSOCIATION, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:OPTA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRAUN
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:214-698-1081
Mailing Address - Street 1:3626 N HALL ST
Mailing Address - Street 2:SUITE 900
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-5105
Mailing Address - Country:US
Mailing Address - Phone:214-698-1081
Mailing Address - Fax:
Practice Address - Street 1:3626 N HALL ST
Practice Address - Street 2:SUITE 900
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-5105
Practice Address - Country:US
Practice Address - Phone:214-698-1081
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-12
Last Update Date:2008-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDB155207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00T522OtherBLUE CROSS
TX00T522Medicare PIN