MEDICARE: BRACHA BROWN RD

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	133V00000X	Registered Dietitian	DT87388	TX

General Provider Information

NPI Number	:	1336921410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRACHA BROWN RD

Provider Business Mailing Address
First Line	:	18024 CARROLLWOOD DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6330
Country	:	US
Telephone Number	:	516-784-9271
Fax Number	:

Provider Business Practice Location Address
First Line	:	18024 CARROLLWOOD DR
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75252-6330
Country	:	US
Telephone Number	:	516-784-9271
Fax Number	:

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

Provider Enumeration Date	:	10/16/2023
Last Update Date	:	04/19/2026

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Directions to “ BRACHA BROWN RD” Practice Location

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