Individual
CHARLES DAVID BRODRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
303 E QUINCY ST, SUITE 100, SAN ANTONIO, TX 78215-1918
(210) 271-7648
Mailing address
303 E QUINCY ST, SUITE 100, SAN ANTONIO, TX 78215-1918
(210) 271-7648
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
L6300
TX
207WX0107X
Retina Specialist (Ophthalmology) Physician
L6300
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1633471-05
—
TX
05
—
163347104
—
TX
Enumeration date
08/16/2005
Last updated
04/25/2017
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