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General NPI Number Information
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NPI Number | 1922248988
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Entity Type | Organization
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Legal Business Name | ALFRED B. BRADY, M.D., P.A.
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Dates
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Enumeration Date | 03/03/2009
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Last Update Date | 01/28/2010
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Provider Practice Location Address
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Address Line | 755 N 11TH ST SUITE 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 | 409-923-5074
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Provider Business Mailing Address
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Address Line | 755 N 11TH ST SUITE 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 | 409-923-5074
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Authorized Official
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Title or Position | M.D.
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Name | DR. ALFRED B BRADY
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Credential | M.D.
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Telephone | 409-892-1192
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | D3567
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License Number State | TX
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