Provider Demographics
NPI:1750510814
Name:AU, BRIGHAM KANAKANUIOKEKAI (MD)
Entity Type:Individual
Prefix:
First Name:BRIGHAM
Middle Name:KANAKANUIOKEKAI
Last Name:AU
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3533 MATLOCK RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3604
Mailing Address - Country:US
Mailing Address - Phone:817-419-0303
Mailing Address - Fax:833-626-1951
Practice Address - Street 1:3533 MATLOCK RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3604
Practice Address - Country:US
Practice Address - Phone:817-419-0303
Practice Address - Fax:833-626-1951
Is Sole Proprietor?:No
Enumeration Date:2009-07-10
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP3686207X00000X, 207XX0801X, 207XX0801X
FLME118980207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLHX057ZMedicare PIN