Individual
DR. RICHARD G BRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSY.D.
Contact information
Practice address
15321 SAN PEDRO AVE STE 102, SAN ANTONIO, TX 78232-3712
(210) 587-6177
(210) 587-6178
Mailing address
15321 SAN PEDRO AVE STE 102, SAN ANTONIO, TX 78232-3712
(210) 587-6177
(210) 587-6178
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
14197
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160425801
—
TX
Enumeration date
10/27/2006
Last updated
10/15/2014
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