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NPI Code Detail

MEDICARE: DR. CANDICE BRAERMAN TEUNIS M.D.

MEDICARE: DR. CANDICE BRAERMAN TEUNIS 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
1207X00000XOrthopaedic Surgery PhysicianN6712TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
39022686OTHERTXAETNA
48AD236OTHERTXBCBS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1316105620
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CANDICE BRAERMAN TEUNIS M.D.
Provider Business Mailing Address
First Line : 909 FROSTWOOD DR
Second Line : SUITE 1.100
City : HOUSTON
State : TX
Zip : 77024-2301
Country : US
Telephone Number : 281-344-1715
Fax Number :
Provider Business Practice Location Address
First Line : 1517 THOMPSON RD
Second Line :
City : RICHMOND
State : TX
Zip : 77469-4932
Country : US
Telephone Number : 281-344-1715
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2008
Last Update Date : 06/29/2012

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