Individual
TOM BREAZEAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3601 4TH ST # MS 8182, LUBBOCK, TX 79430-0002
(806) 743-9945
Mailing address
10714 ASHLESHA LN, RICHMOND, TX 77406-2965
(208) 661-6510
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
789790577
TX
390200000X
Student in an Organized Health Care Education/Training Program
—
TX
Other
Enumeration date
03/22/2025
Last updated
05/20/2025
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