Organization
BRAD A. BRAZEAL MD PA
Active
Organization
BRAD A. BRAZEAL MD PA
Active
Other names
Brad A. Brazeal MD PA
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRAD A BRAZEAL MD (SELF/OWNER)
(903) 723-1940
Entity
Organization
Contact information
Practice address
300 WILLOW CREEK PKWY, STE 210, PALESTINE, TX 75801-4421
(903) 723-1940
(903) 723-8307
Mailing address
300 WILLOW CREEK PKWY, STE 210, PALESTINE, TX 75801-4421
(903) 723-1940
(903) 723-8307
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
50509
TX
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
50509
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
124200005
—
TX
05
—
166535801
—
TX
Enumeration date
09/06/2007
Last updated
02/01/2016
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