Individual
PETE C BRAVO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2777 E SOUTHLAKE BLVD STE 140, SOUTHLAKE, TX 76092-8017
(817) 686-8104
Mailing address
2001 BUTTERFIELD RD, STE 300, DOWNERS GROVE, IL 60515-1069
(630) 725-2700
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP140592
TX
363LP2300X
Primary Care Nurse Practitioner
AP140592
TX
Other
Enumeration date
02/12/2019
Last updated
01/13/2020
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