Provider Demographics
NPI:1205259389
Name:ERIC J. BRAHIN, MD, PLLC
Entity type:Organization
Organization Name:ERIC J. BRAHIN, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRAHIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-266-4076
Mailing Address - Street 1:2600 SW MILITARY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78224-1028
Mailing Address - Country:US
Mailing Address - Phone:210-923-2700
Mailing Address - Fax:210-923-4003
Practice Address - Street 1:2600 SW MILITARY DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78224-1028
Practice Address - Country:US
Practice Address - Phone:210-923-2700
Practice Address - Fax:210-927-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-27
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN55862084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX284639601Medicaid
TX338127Medicare PIN