Provider Demographics
NPI:1982640736
Name:BRADY, YOLANDA COWLEY (MD)
Entity Type:Individual
Prefix:
First Name:YOLANDA
Middle Name:COWLEY
Last Name:BRADY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 N HIGHWAY 77
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-1128
Mailing Address - Country:US
Mailing Address - Phone:972-923-1686
Mailing Address - Fax:972-937-7731
Practice Address - Street 1:505 N HIGHWAY 77
Practice Address - Street 2:SUITE 200
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1128
Practice Address - Country:US
Practice Address - Phone:972-923-1686
Practice Address - Fax:972-937-7731
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG8020207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8F5192OtherBCBS
TX8BR072OtherBCBS
TX0978504-04Medicaid
TX097850405Medicaid
TX8L5646Medicare PIN
TXP00720746Medicare PIN
TX8F5192OtherBCBS
TX8BR072OtherBCBS
TXP00249434Medicare PIN