MEDICARE: DR. CHRISTOPHER WALTON BRENNIG 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
1	2086S0129X	Vascular Surgery Physician	L5999	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	8BW995	OTHER	TX	BCBS

General Provider Information

NPI Number	:	1922103159
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER WALTON BRENNIG M.D.

Provider Business Mailing Address
First Line	:	7000 NORTH MOPAC EXPRESSWAY
Second Line	:	SUITE 320
City	:	AUSTIN
State	:	TX
Zip	:	78731-3258
Country	:	US
Telephone Number	:	512-346-8346
Fax Number	:	512-346-8343

Provider Business Practice Location Address
First Line	:	7000 NORTH MOPAC EXPRESSWAY
Second Line	:	SUITE 320
City	:	AUSTIN
State	:	TX
Zip	:	78731-3258
Country	:	US
Telephone Number	:	512-346-8346
Fax Number	:	512-346-8343

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

Provider Enumeration Date	:	09/13/2006
Last Update Date	:	03/04/2009

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