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Organization
MICHAEL R. BRANCHEAU M.D., PLLC
Active
Organization
MICHAEL R. BRANCHEAU M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL RAYMOND BRANCHEAU M.D. (OWNER)
(214) 321-3394
Entity
Organization
Contact information
Practice address
9330 POPPY DR STE 503, DALLAS, TX 75218-4696
(214) 321-3394
(214) 321-3469
Mailing address
9330 POPPY DR STE 503, DALLAS, TX 75218-4696
(214) 321-3394
(214) 321-3469
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
K2854
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
45D2110775
CLIA WAIVER
—
Enumeration date
07/29/2015
Last updated
01/11/2017
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