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Individual
DR. TAMMY L. BROXSON
Active
Individual
DR. TAMMY L. BROXSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L4488
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0020KW
BCBS PROVIDER ID
TX
01
—
05-0622563
TAX NUMBER
TX
01
—
7313193
AETNA PIN NUMBER
TX
01
—
L4488
MEDICAL LICENSE
TX
Enumeration date
05/08/2006
Last updated
08/10/2016
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