Individual
BRACKEN SCOTT KOLLE
Active
Individual
BRACKEN SCOTT KOLLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
M5300
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194638601
—
TX
05
—
194638602
—
TX
01
—
8BK830
BCBS OF TEXAS
TX
01
—
P00824287
RR MEDICARE
TX
Enumeration date
09/19/2007
Last updated
05/06/2020
Update your record
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