Provider Demographics
NPI:1730282708
Name:BRICKMAN, ELIZABETH S (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:S
Last Name:BRICKMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 CAMDEN
Mailing Address - Street 2:SUITE 214
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78215
Mailing Address - Country:US
Mailing Address - Phone:210-226-5929
Mailing Address - Fax:210-226-0925
Practice Address - Street 1:311 CAMDEN
Practice Address - Street 2:SUITE 214
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215
Practice Address - Country:US
Practice Address - Phone:210-226-5929
Practice Address - Fax:210-226-0925
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-06
Last Update Date:2012-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3178208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1215386 01Medicaid
TX121538603Medicaid
TX1215386 01Medicaid