Provider Demographics
NPI:1013138726
Name:BRENDAN C. ALBRACHT, D.O.,P.A.
Entity Type:Organization
Organization Name:BRENDAN C. ALBRACHT, D.O.,P.A.
Other - Org Name:ALBRACHT ORTHOPEDIC SURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALBRACHT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:806-935-6300
Mailing Address - Street 1:1901 MEDI PARK DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2110
Mailing Address - Country:US
Mailing Address - Phone:806-242-6637
Mailing Address - Fax:806-242-6007
Practice Address - Street 1:1901 MEDI PARK DR
Practice Address - Street 2:SUITE 103
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2110
Practice Address - Country:US
Practice Address - Phone:806-242-6637
Practice Address - Fax:806-242-6007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-01
Last Update Date:2011-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7966207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Y089OtherMEDICARE PTAN