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General NPI Number Information
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NPI Number | 1437542982
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Entity Type | Organization
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Legal Business Name | CHARLES DAVID BRAUNGARDT
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 03/09/2015
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Provider Practice Location Address
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Address Line | 7221 MEADOWBROOK DR
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City | FORT WORTH
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State | TX
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Zip | 76112-5327
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Country | US
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Telephone | 817-999-0639
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Fax |
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Provider Business Mailing Address
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Address Line | 7221 MEADOWBROOK DR
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City | FORT WORTH
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State | TX
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Zip | 76112-5327
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Country | US
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Telephone | 817-999-0639
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Fax |
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Authorized Official
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Title or Position | MD
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Name | CHARLES DAVID BRAUNGARDT
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Credential | MD
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Telephone | 817-999-0639
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | C7551
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License Number State | TX
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