Individual
AMY BRAZDA EASTMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3142 HORIZON RD STE 110, ROCKWALL, TX 75032-7810
(972) 771-3322
(972) 771-0272
Mailing address
PO BOX 911230, DALLAS, TX 75391-1230
(972) 997-8000
(972) 234-0813
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
N9174
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
353314302
—
TX
01
—
BP1-0026519
INSTITUTIONAL PERMIT
—
01
—
P01932486
RAILROAD
TX
Enumeration date
06/13/2007
Last updated
04/05/2018
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