Individual
TIRA CHAICHA-BROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6500 N MOPAC, BLDG 3, STE 200, AUSTIN, TX 78731-4309
(512) 458-8400
(512) 458-8593
Mailing address
6500 N MOPAC, BLDG 3, STE 200, AUSTIN, TX 78731-4309
(512) 458-8400
(512) 458-8593
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
P5049
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8DP866
BCBS INDIVIDUAL
TX
01
—
P5049
STATE LICENSE
TX
Enumeration date
04/17/2008
Last updated
06/19/2014
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