MEDICARE: MARY JANE EMILY BRAUNSTEIN M.D.

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	207V00000X	Obstetrics & Gynecology Physician	J6347	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	8J9153	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1265449623
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARY JANE EMILY BRAUNSTEIN M.D.

Provider Business Mailing Address
First Line	:	205 E UNIVERSITY AVE
Second Line	:
City	:	GEORGETOWN
State	:	TX
Zip	:	78626-6814
Country	:	US
Telephone Number	:	512-454-5721
Fax Number	:

Provider Business Practice Location Address
First Line	:	11111 RESEARCH BLVD
Second Line	:	SUITE 230
City	:	AUSTIN
State	:	TX
Zip	:	78759-5264
Country	:	US
Telephone Number	:	512-795-4620
Fax Number	:

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

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	02/23/2021

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