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NPI Code Detail

MEDICARE: CHEVELLE BRUDEY MD PLLC

MEDICARE: CHEVELLE BRUDEY MD PLLC
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
12084P0800XPsychiatry Physician

General Provider Information

NPI Number : 1326829094
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHEVELLE BRUDEY MD PLLC
Provider Business Mailing Address
First Line : PO BOX 797182
Second Line :
City : DALLAS
State : TX
Zip : 75379-7182
Country : US
Telephone Number : 214-420-9301
Fax Number : 659-903-2614
Provider Business Practice Location Address
First Line : 14275 MIDWAY RD STE 200
Second Line :
City : ADDISON
State : TX
Zip : 75001-3618
Country : US
Telephone Number : 214-420-9301
Fax Number : 659-903-2614
Authorized Official
Title or Position : PSYCHIATRIST
Name : DR. CHEVELLE BRUDEY
Credential : MD
Telephone Number : 888-806-1928
Provider Enumeration Date : 10/10/2023
Last Update Date : 05/21/2024

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