MEDICARE: DR. CARL MARTIN BROFMAN D.C., NP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	7111	TX
2	363L00000X	Nurse Practitioner	777173	TX
3	363LF0000X	Family Nurse Practitioner	777173	TX
4	363LF0000X	Family Nurse Practitioner	AP120381	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0034GH	OTHER	TX	BC/BS GROUP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	0071653	OTHER	TX	BLUELINK ID
4	8A8401	OTHER	TX	BC/BS PROVIDER ID

General Provider Information

NPI Number	:	1003831967
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL MARTIN BROFMAN D.C., NP-C

Provider Business Mailing Address
First Line	:	1820 HARVARD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-4342
Country	:	US
Telephone Number	:	409-283-1950
Fax Number	:

Provider Business Practice Location Address
First Line	:	1820 HARVARD ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77008-4342
Country	:	US
Telephone Number	:	409-283-1950
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/13/2006
Last Update Date	:	06/26/2025

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