Individual
DENEANE STORCK BRADY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
6606 LBJ FWY, SUITE 200, DALLAS, TX 75240
(972) 715-1999
(972) 233-3666
Mailing address
PO BOX 840853, DALLAS, TX 75284-0853
(972) 233-1999
(972) 233-3666
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP120300
TX
367500000X
Certified Registered Nurse Anesthetist
R1290660
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125895800
—
MN
05
—
284448204
—
TX
01
—
8672UJ
BCBS
TX
01
—
P01445705
RAILROAD
TX
Enumeration date
03/09/2006
Last updated
06/01/2018
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