Provider Demographics
NPI:1417995424
Name:TOWELL, BRENDA L (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENDA
Middle Name:L
Last Name:TOWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-0813
Practice Address - Street 1:1401 MEDICAL PKWY
Practice Address - Street 2:SUITE 412
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-7763
Practice Address - Country:US
Practice Address - Phone:512-260-6050
Practice Address - Fax:512-260-6080
Is Sole Proprietor?:No
Enumeration Date:2006-06-02
Last Update Date:2014-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8752207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136847410Medicaid
TX136847402Medicaid
TXP00646001OtherRAILROAD MEDICARE
TX0811853-01Medicaid
TX136847411Medicaid
TX8BP362OtherBCBS OF TX
TX830004594OtherRAILROAD MEDICARE NUMBER
TX136847411Medicaid
TX8L1692Medicare PIN
TN0080BYMedicare UPIN
TX136847410Medicaid