Provider Demographics
NPI:1952458986
Name:RAPPE, BRIAN DAVID (DO)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:DAVID
Last Name:RAPPE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2613 SOUTHLAND BLVD
Mailing Address - Street 2:#10
Mailing Address - City:SAN ANGELO
Mailing Address - State:TX
Mailing Address - Zip Code:76904-7551
Mailing Address - Country:US
Mailing Address - Phone:325-650-8516
Mailing Address - Fax:
Practice Address - Street 1:2613 SOUTHLAND BLVD
Practice Address - Street 2:#10
Practice Address - City:SAN ANGELO
Practice Address - State:TX
Practice Address - Zip Code:76904-7551
Practice Address - Country:US
Practice Address - Phone:325-650-8516
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2009-07-14
Deactivation Date:2009-02-23
Deactivation Code:
Reactivation Date:2009-03-03
Provider Licenses
StateLicense IDTaxonomies
TXJ4981208D00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF36166Medicare UPIN