Provider Demographics
NPI:1922103159
Name:BRENNIG, CHRISTOPHER WALTON (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:WALTON
Last Name:BRENNIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 NORTH MOPAC EXPRESSWAY
Mailing Address - Street 2:SUITE 320
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3258
Mailing Address - Country:US
Mailing Address - Phone:512-346-8346
Mailing Address - Fax:512-346-8343
Practice Address - Street 1:7000 NORTH MOPAC EXPRESSWAY
Practice Address - Street 2:SUITE 320
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3258
Practice Address - Country:US
Practice Address - Phone:512-346-8346
Practice Address - Fax:512-346-8343
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-13
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL59992086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BW995OtherBCBS
TX8J2159Medicare PIN
TX8BW995OtherBCBS
TXI68583Medicare UPIN