Provider Demographics
NPI:1982145264
Name:BRADEN, STACI SCHNEIDER (DC)
Entity type:Individual
Prefix:DR
First Name:STACI
Middle Name:SCHNEIDER
Last Name:BRADEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 ABNER JACKSON PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:LAKE JACKSON
Mailing Address - State:TX
Mailing Address - Zip Code:77566-5156
Mailing Address - Country:US
Mailing Address - Phone:979-480-9922
Mailing Address - Fax:
Practice Address - Street 1:113 ABNER JACKSON PKWY STE C
Practice Address - Street 2:
Practice Address - City:LAKE JACKSON
Practice Address - State:TX
Practice Address - Zip Code:77566-5156
Practice Address - Country:US
Practice Address - Phone:979-480-9922
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-20
Last Update Date:2019-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13402111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor