Provider Demographics
NPI:1588787642
Name:DAVID A BRAUNREITER, MD, PA
Entity type:Organization
Organization Name:DAVID A BRAUNREITER, MD, PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ANTHONY
Authorized Official - Last Name:BRAUNREITER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-499-4011
Mailing Address - Street 1:5819 HIGHWAY 6
Mailing Address - Street 2:SUITE 380
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-4052
Mailing Address - Country:US
Mailing Address - Phone:281-499-4011
Mailing Address - Fax:281-499-4490
Practice Address - Street 1:5819 HIGHWAY 6
Practice Address - Street 2:SUITE 380
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-4052
Practice Address - Country:US
Practice Address - Phone:281-499-4011
Practice Address - Fax:281-499-4490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8026207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF82176Medicare UPIN
TX00637XMedicare ID - Type Unspecified