Provider Demographics
NPI:1972572055
Name:BRAUNREITER, DAVID ANTHONY (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:ANTHONY
Last Name:BRAUNREITER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16811 SOUTHWEST FWY
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-4728
Mailing Address - Country:US
Mailing Address - Phone:281-690-4678
Mailing Address - Fax:
Practice Address - Street 1:16811 SOUTHWEST FWY
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-4728
Practice Address - Country:US
Practice Address - Phone:281-690-4678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8026207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX047591502Medicaid
TX047591506Medicaid
TX047591507Medicaid
TX047591505Medicaid
TX610119705 BROOKSOtherUS DEPT OF LABOR
TX0061LPOtherBLUE CROSS BLUE SHIELD
TX047591504Medicaid
TX047591503Medicaid
TX047591508Medicaid
TX610119701OtherUS DEPT OF LABOR
TXP00976676OtherMEDICARE RR
TXP01078363OtherRR MEDICARE
TX610119701OtherUS DEPT OF LABOR
TX047591508Medicaid
TX047591507Medicaid
TXTXB151078Medicare PIN
TX047591504Medicaid
TXTXB151077Medicare PIN