Provider Demographics
NPI:1922560184
Name:BREIO HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:BREIO HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:FARRAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:817-657-4894
Mailing Address - Street 1:520 E VINE ST
Mailing Address - Street 2:
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76244-3919
Mailing Address - Country:US
Mailing Address - Phone:817-657-4894
Mailing Address - Fax:
Practice Address - Street 1:2507 MEDICAL ROW
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1070
Practice Address - Country:US
Practice Address - Phone:817-657-4894
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational HealthGroup - Multi-Specialty
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2139Other1497252139