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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