Provider Demographics
NPI:1356709083
Name:BRITEX
Entity type:Organization
Organization Name:BRITEX
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:BRENDAN
Authorized Official - Middle Name:BOOKER
Authorized Official - Last Name:LOEHR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:512-960-7997
Mailing Address - Street 1:10200 BOULDER LN
Mailing Address - Street 2:300
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78726-1807
Mailing Address - Country:US
Mailing Address - Phone:512-362-7130
Mailing Address - Fax:
Practice Address - Street 1:10200 BOULDER LANE
Practice Address - Street 2:#300
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78726
Practice Address - Country:US
Practice Address - Phone:512-362-7130
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-09
Last Update Date:2016-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30932122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty