Provider Demographics
NPI:1912503038
Name:BRANSKY, DAWN RENEE
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:RENEE
Last Name:BRANSKY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6604 BAKER CT
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-5751
Mailing Address - Country:US
Mailing Address - Phone:817-680-6810
Mailing Address - Fax:
Practice Address - Street 1:4001 AIRPORT FWY STE 190
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76021-6197
Practice Address - Country:US
Practice Address - Phone:817-680-6810
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-05
Last Update Date:2020-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1116473261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy