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Individual
KIKI D. BRABHAM
Active
Individual
KIKI D. BRABHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA03755
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8N9128
BLUE SHIELD
TX
Enumeration date
04/08/2006
Last updated
07/12/2012
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