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General NPI Number Information
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NPI Number | 1255790614
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Entity Type | Individual
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Provider Name | BRUT BEWKETU D.C.
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Gender | Female
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Dates
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Enumeration Date | 02/14/2016
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Last Update Date | 01/29/2022
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Provider Practice Location Address
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Address Line | 150 BRAND RD UNIT 500
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City | MURPHY
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State | TX
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Zip | 75094
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Country | US
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Telephone | 972-905-5659
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Fax | 972-905-5593
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Provider Business Mailing Address
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Address Line | 150 BRAND RD UNIT 500
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City | MURPHY
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State | TX
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Zip | 75094-3734
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Country | US
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Telephone | 972-905-5659
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 13034
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License Number State | TX
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