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General NPI Number Information
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NPI Number | 1871661124
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Entity Type | Individual
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Provider Name | BRADY E ANDERSON M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/02/2006
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Last Update Date | 06/11/2024
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Provider Practice Location Address
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Address Line | 1180 SETON PKWY STE 220
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City | KYLE
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State | TX
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Zip | 78640-6179
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Country | US
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Telephone | 512-504-0877
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Fax | 512-504-0864
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Provider Business Mailing Address
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Address Line | 7200 WYOMING SPGS SUITE 500
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City | ROUND ROCK
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State | TX
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Zip | 78681-4303
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Country | US
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Telephone | 512-244-0111
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Fax | 512-244-2479
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | M0343
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License Number State | TX
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