MEDICARE: DR. CARLA C BRAXTON MD

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	208600000X	Surgery Physician	04-29699	KS
2	2086S0102X	Surgical Critical Care Physician	04-29699	KS
3	208600000X	Surgery Physician	P8222	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	436730	OTHER	KS	FIRSTGUARD
4	8GD827	OTHER	TX	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	8FB774	OTHER	TX	BLUE CROSS BLUE SHIELD
8	31519012	OTHER	MO	BCBS KANSAS CITY

General Provider Information

NPI Number	:	1427157700
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLA C BRAXTON MD

Provider Business Mailing Address
First Line	:	18400 KATY FWY
Second Line	:	SUITE 560
City	:	HOUSTON
State	:	TX
Zip	:	77094-1286
Country	:	US
Telephone Number	:	832-522-3240
Fax Number	:

Provider Business Practice Location Address
First Line	:	18400 KATY FWY
Second Line	:	SUITE 560
City	:	HOUSTON
State	:	TX
Zip	:	77094-1286
Country	:	US
Telephone Number	:	832-522-3240
Fax Number	:

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

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	12/19/2016

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Directions to “ DR. CARLA C BRAXTON MD” Practice Location

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