Provider Demographics
NPI:1952505547
Name:BRANTLEY, JULIE SRACIC (MD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:SRACIC
Last Name:BRANTLEY
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:15200 SOUTHWEST FWY
Mailing Address - Street 2:STE 150
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3843
Mailing Address - Country:US
Mailing Address - Phone:281-240-4313
Mailing Address - Fax:281-240-3646
Practice Address - Street 1:2225 WILLIAMS TRACE BLVD
Practice Address - Street 2:#112
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-4513
Practice Address - Country:US
Practice Address - Phone:281-313-0006
Practice Address - Fax:281-265-3393
Is Sole Proprietor?:No
Enumeration Date:2007-06-14
Last Update Date:2021-01-18
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXM2910207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB111012Medicare PIN
TXTXB111013Medicare PIN