Provider Demographics
NPI:1558350181
Name:BRAMHALL, JOE P (MD)
Entity Type:Individual
Prefix:DR
First Name:JOE
Middle Name:P
Last Name:BRAMHALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5026 AUGUSTA CIR
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-8983
Mailing Address - Country:US
Mailing Address - Phone:979-690-7800
Mailing Address - Fax:
Practice Address - Street 1:3121 UNIVERSITY DR E STE 100
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-3499
Practice Address - Country:US
Practice Address - Phone:979-776-0169
Practice Address - Fax:979-776-1372
Is Sole Proprietor?:No
Enumeration Date:2005-10-17
Last Update Date:2020-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0207207XX0005X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX122612803Medicaid
TX88345XOtherBLUECROSS
TXB21457Medicare UPIN
TX00216NMedicare PIN