Provider Demographics
NPI:1477725679
Name:ALAN R BRAID MDPA
Entity Type:Organization
Organization Name:ALAN R BRAID MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MCCLENDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-615-0866
Mailing Address - Street 1:4499 MEDICAL DR STE 230
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3712
Mailing Address - Country:US
Mailing Address - Phone:210-615-0866
Mailing Address - Fax:210-615-8321
Practice Address - Street 1:4499 MEDICAL DR STE 230
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3712
Practice Address - Country:US
Practice Address - Phone:210-615-0866
Practice Address - Fax:210-615-8321
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-27
Last Update Date:2008-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE3654207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXC13703Medicare UPIN
TX00H33CMedicare PIN