MEDICARE: JOHN MICHAEL BRENNAN M.D, P.A.

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	2084P0800X	Psychiatry Physician	J3750	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	4480010	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1336123173
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN MICHAEL BRENNAN M.D, P.A.

Provider Business Mailing Address
First Line	:	7557 RAMBLER RD STE 565
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2373
Country	:	US
Telephone Number	:	214-824-2273
Fax Number	:	214-826-9340

Provider Business Practice Location Address
First Line	:	7557 RAMBLER RD STE 565
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75231-2373
Country	:	US
Telephone Number	:	214-824-2273
Fax Number	:	214-826-9340

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

Provider Enumeration Date	:	12/05/2005
Last Update Date	:	12/02/2025

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