Individual
JOSE L BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
313 E 12TH ST STE 100, AUSTIN, TX 78701-1955
(512) 324-8960
(512) 324-8962
Mailing address
1601 RIO GRANDE ST STE 348, AUSTIN, TX 78701-1149
(512) 324-8960
(512) 324-8962
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G4853
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G4853
LICENSE
TX
Enumeration date
02/28/2007
Last updated
07/08/2007
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