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General NPI Number Information
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NPI Number | 1841293909
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Entity Type | Individual
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Provider Name | ALFRED B. BRADY JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 03/30/2011
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Provider Practice Location Address
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Address Line | 755 N 11TH ST STE P2200
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City | BEAUMONT
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State | TX
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Zip | 77702-1500
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Country | US
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Telephone | 409-892-1192
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Fax | 409-924-9012
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Provider Business Mailing Address
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Address Line | 755 N 11TH ST STE P2200
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City | BEAUMONT
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State | TX
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Zip | 77702-1500
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Country | US
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Telephone | 409-892-1192
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Fax | 409-924-9012
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | D3567
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License Number State | TX
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