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General NPI Number Information
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NPI Number | 1700163060
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Entity Type | Organization
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Legal Business Name | BRENDA L. AXMANN, M.D P.A.
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Dates
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Enumeration Date | 11/14/2011
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Last Update Date | 11/14/2011
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Provider Practice Location Address
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Address Line | 6124 W PARKER RD STE 334
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City | PLANO
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State | TX
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Zip | 75093-8123
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Country | US
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Telephone | 972-378-0068
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Fax |
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Provider Business Mailing Address
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Address Line | 6124 W PARKER RD STE 334
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City | PLANO
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State | TX
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Zip | 75093-8123
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Country | US
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Telephone | 972-378-0068
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. BRENDA L AXMANN
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Credential | M.D.
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Telephone | 972-378-0068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | H5417
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License Number State | TX
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