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General NPI Number Information
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NPI Number | 1871304303
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Entity Type | Individual
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Provider Name | MRS. RACHEL LYNN BRAZEE
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Gender | Female
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Dates
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Enumeration Date | 01/15/2025
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Last Update Date | 01/15/2025
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Provider Practice Location Address
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Address Line | 200 N KIMBALL AVE STE 206
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City | SOUTHLAKE
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State | TX
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Zip | 76092-6660
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Country | US
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Telephone | 817-769-4731
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Fax |
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Provider Business Mailing Address
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Address Line | 1504 EL CAMINO REAL
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City | EULESS
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State | TX
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Zip | 76040-6557
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Country | US
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Telephone | 682-217-9676
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 12370
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License Number State | TX
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