MEDICARE: DR. KAREN LEE BRUNE D.D.S.

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	1223G0001X	General Practice Dentistry	16247	TX

General Provider Information

NPI Number	:	1811059165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KAREN LEE BRUNE D.D.S.

Provider Business Mailing Address
First Line	:	1300 POST OAK BLVD
Second Line	:	#1620
City	:	HOUSTON
State	:	TX
Zip	:	77056-3043
Country	:	US
Telephone Number	:	713-622-6112
Fax Number	:	713-622-2351

Provider Business Practice Location Address
First Line	:	1300 POST OAK BLVD
Second Line	:	#1620
City	:	HOUSTON
State	:	TX
Zip	:	77056-3043
Country	:	US
Telephone Number	:	713-622-6112
Fax Number	:	713-622-2351

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

Provider Enumeration Date	:	12/14/2006
Last Update Date	:	07/08/2007

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