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Individual
DR. KENNETH PAUL BRASSIE
Active
Individual
DR. KENNETH PAUL BRASSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
10149
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0067MY
BCBS GROUP #
TX
01
—
628577
PHCS
TX
01
—
8F1781
MEDICARE INDIVIDUAL
TX
01
—
8U4210
BCBS INDIVIDUAL #
TX
Enumeration date
11/01/2006
Last updated
03/06/2008
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