Individual
DR. JUSTIN R. BRAZEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2803 EARL RUDDER FWY S, SUITE 103, COLLEGE STATION, TX 77845-6099
(979) 731-8888
Mailing address
2803 EARL RUDDER FWY S, SUITE 103, COLLEGE STATION, TX 77845-6099
(979) 731-8888
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
N6826
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
282074801
—
TX
05
—
307869301
—
TX
Enumeration date
11/08/2007
Last updated
01/21/2013
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