Provider Demographics
NPI:1407134612
Name:BRAWLEY, DANIEL CADE (DDS)
Entity Type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:CADE
Last Name:BRAWLEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8220 MEMPHIS AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79423-2612
Mailing Address - Country:US
Mailing Address - Phone:806-745-1745
Mailing Address - Fax:
Practice Address - Street 1:8220 MEMPHIS AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79423-2612
Practice Address - Country:US
Practice Address - Phone:806-745-1745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2016-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX271501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice