MEDICARE: MR. THOMAS CUNNING BRAMHALL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Y00000X	Otolaryngology Physician	K0645	TX

General Provider Information

NPI Number	:	1265439962
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. THOMAS CUNNING BRAMHALL MD

Provider Business Mailing Address
First Line	:	324 WEST MAIN ST
Second Line	:	SUITE 100
City	:	LEWISVILLE
State	:	TX
Zip	:	75057-3640
Country	:	US
Telephone Number	:	972-420-7212
Fax Number	:	972-420-8812

Provider Business Practice Location Address
First Line	:	324 WEST MAIN ST
Second Line	:	SUITE 100
City	:	LEWISVILLE
State	:	TX
Zip	:	75057-3640
Country	:	US
Telephone Number	:	972-420-7212
Fax Number	:	972-420-8812

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	07/24/2008

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