Organization
EMERALD MEDICAL NY PC
Active
Other names
Everly Provider Group NY
Organization subpart
No
Provider details
NPI number
Authorized official
BRANTLEY JOLLY MD (PRESIDENT/OWNER)
(855) 422-3855
Entity
Organization
Contact information
Practice address
823 CONGRESS AVE STE 1200, AUSTIN, TX 78701-2402
(855) 422-3855
Mailing address
823 CONGRESS AVE STE 1200, AUSTIN, TX 78701-2402
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/23/2024
Last updated
05/23/2024
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