1598732208 NPI number — DR. MICHAEL D BROPHEY M.D

Table of content: DR. MICHAEL D BROPHEY M.D (NPI 1598732208)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598732208 NPI number — DR. MICHAEL D BROPHEY M.D

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROPHEY
Provider First Name:
MICHAEL
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1598732208
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14800 LANDMARK BLVD
Provider Second Line Business Mailing Address:
SUITE 700
Provider Business Mailing Address City Name:
DALLAS
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75254-7565
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-391-1915
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
621 N HALL ST
Provider Second Line Business Practice Location Address:
SUITE 500
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75226-1339
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-841-2000
Provider Business Practice Location Address Fax Number:
214-841-2015
Provider Enumeration Date:
03/01/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207UN0901X , with the licence number:  H2264 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 134653807 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 134653802 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 134653801 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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