Provider Demographics
NPI:1194722876
Name:BRASWELL, LEZLI ANN (MD)
Entity type:Individual
Prefix:DR
First Name:LEZLI
Middle Name:ANN
Last Name:BRASWELL
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 CHURCHILL DR STE 100
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1895
Mailing Address - Country:US
Mailing Address - Phone:972-914-9421
Mailing Address - Fax:915-331-9482
Practice Address - Street 1:2601 CHURCHILL DR STE 100
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1895
Practice Address - Country:US
Practice Address - Phone:972-914-9421
Practice Address - Fax:915-331-9481
Is Sole Proprietor?:No
Enumeration Date:2005-07-07
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5684207Q00000X
GA59608207Q00000X
NY272137207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA738576762AMedicaid
GA738576762AMedicaid
GA511I080144Medicare PIN