Provider Demographics
NPI:1750505236
Name:BRASHEAR FAMILY MEDICAL, P.A.
Entity Type:Organization
Organization Name:BRASHEAR FAMILY MEDICAL, P.A.
Other - Org Name:BRASHEAR FAMILY MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:BRASHEAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-932-8555
Mailing Address - Street 1:2300 COMMERCE WAY
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-7361
Mailing Address - Country:US
Mailing Address - Phone:972-932-8555
Mailing Address - Fax:972-932-2141
Practice Address - Street 1:2300 COMMERCE WAY
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-7361
Practice Address - Country:US
Practice Address - Phone:972-932-8555
Practice Address - Fax:972-932-2141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL4871261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH72921Medicare UPIN
TX00X880Medicare PIN