Provider Demographics
NPI:1598935546
Name:BRAYER, ALICE (LM)
Entity Type:Individual
Prefix:MS
First Name:ALICE
Middle Name:
Last Name:BRAYER
Suffix:
Gender:F
Credentials:LM
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:ALICE
Other - Last Name:BRAYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LM
Mailing Address - Street 1:18106 STONE ANGEL DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-3502
Mailing Address - Country:US
Mailing Address - Phone:281-319-6262
Mailing Address - Fax:281-852-6114
Practice Address - Street 1:503 N AVENUE H
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-3850
Practice Address - Country:US
Practice Address - Phone:281-319-6262
Practice Address - Fax:281-852-6114
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-05
Last Update Date:2008-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX96056176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife