Provider Demographics
NPI:1376365023
Name:BRTM-EE LLC
Entity type:Organization
Organization Name:BRTM-EE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DEBORA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELTZ
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:512-827-3601
Mailing Address - Street 1:PO BOX 171078
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TN
Mailing Address - Zip Code:78717
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 BUTTERCUP CREEK BLVD
Practice Address - Street 2:SUITE 104
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78717
Practice Address - Country:US
Practice Address - Phone:512-827-3601
Practice Address - Fax:512-777-5042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty