Healthcare Provider Details

I. General information

NPI: 1952822512
Provider Name (Legal Business Name): BRACANE COMPANY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/04/2017
Last Update Date: 07/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 E. 15TH ST. SUITE 204
PLANO TX
75074-6238
US

IV. Provider business mailing address

2300 MCDERMOTT RD # 200-142
PLANO TX
75025-7016
US

V. Phone/Fax

Practice location:
  • Phone: 888-568-4271
  • Fax: 972-727-6239
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State

VIII. Authorized Official

Name: PAMELA NELSON
Title or Position: PRESIDENT/CEO
Credential: RN
Phone: 888-568-4271