Provider Demographics
NPI:1427350131
Name:MELVIN L. BRAM ,M.D.,P.A.
Entity type:Organization
Organization Name:MELVIN L. BRAM ,M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:L
Authorized Official - Last Name:BRAM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-359-5494
Mailing Address - Street 1:5211 W 9TH AVE
Mailing Address - Street 2:101
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4120
Mailing Address - Country:US
Mailing Address - Phone:806-359-5494
Mailing Address - Fax:806-359-5151
Practice Address - Street 1:5211 W 9TH AVE
Practice Address - Street 2:101
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4120
Practice Address - Country:US
Practice Address - Phone:806-359-5494
Practice Address - Fax:806-359-5151
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-01
Last Update Date:2010-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE5689207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX081773601Medicaid
TXB97343Medicare UPIN
TX00BH65Medicare PIN