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NPI Code Detail

MEDICARE: DR. BODO BRAUER M.D.

MEDICARE: DR. BODO BRAUER 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
1207Q00000XFamily Medicine PhysicianH3231TX

General Provider Information

NPI Number : 1679579908
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BODO BRAUER M.D.
Provider Business Mailing Address
First Line : 8555 MEMORIAL BLVD STE 100
Second Line :
City : PORT ARTHUR
State : TX
Zip : 77640-7001
Country : US
Telephone Number : 409-237-6480
Fax Number : 833-749-0330
Provider Business Practice Location Address
First Line : 8555 MEMORIAL BLVD STE 100
Second Line :
City : PORT ARTHUR
State : TX
Zip : 77640-7001
Country : US
Telephone Number : 409-237-6480
Fax Number : 833-749-0330
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/22/2005
Last Update Date : 01/24/2023

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Directions to “ DR. BODO BRAUER M.D.” Practice Location

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