MEDICARE: DR. WHITNEY LORRAINE BRACE PHARMD

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	183500000X	Pharmacist	50034	TX

General Provider Information

NPI Number	:	1528303104
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WHITNEY LORRAINE BRACE PHARMD

Provider Business Mailing Address
First Line	:	11645 ANGUS RD
Second Line	:	SUITE 1
City	:	AUSTIN
State	:	TX
Zip	:	78759-4100
Country	:	US
Telephone Number	:	512-345-1444
Fax Number	:	512-345-7721

Provider Business Practice Location Address
First Line	:	3010 BEE CAVE RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78746-5562
Country	:	US
Telephone Number	:	512-327-7455
Fax Number	:	512-327-3025

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

Provider Enumeration Date	:	12/07/2012
Last Update Date	:	03/04/2020

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