Provider Demographics
NPI:1629251764
Name:WILLIAM C. BRAUDT, P.A.
Entity Type:Organization
Organization Name:WILLIAM C. BRAUDT, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:BRAUDT
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:806-452-7575
Mailing Address - Street 1:10140 W US HIGHWAY 60
Mailing Address - Street 2:
Mailing Address - City:CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79015-5708
Mailing Address - Country:US
Mailing Address - Phone:806-452-7575
Mailing Address - Fax:806-705-8964
Practice Address - Street 1:10140 W US HIGHWAY 60
Practice Address - Street 2:
Practice Address - City:CANYON
Practice Address - State:TX
Practice Address - Zip Code:79015-5708
Practice Address - Country:US
Practice Address - Phone:806-452-7575
Practice Address - Fax:806-705-8964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8561111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX608008OtherBLUE CROSS/BLUE SHIELD
TX7321347OtherAETNA
TX0085543OtherBLUE LINK
TX00182XMedicare PIN
TX608008OtherBLUE CROSS/BLUE SHIELD