Provider Demographics
NPI:1871707877
Name:BRAZIEL, BRETT RAY (PT, MPT)
Entity type:Individual
Prefix:MR
First Name:BRETT
Middle Name:RAY
Last Name:BRAZIEL
Suffix:
Gender:M
Credentials:PT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2126 HAMILTON DR STE 230
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-2129
Mailing Address - Country:US
Mailing Address - Phone:940-591-7071
Mailing Address - Fax:940-591-7002
Practice Address - Street 1:2126 HAMILTON DR STE 230
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-2129
Practice Address - Country:US
Practice Address - Phone:940-591-7071
Practice Address - Fax:940-591-7002
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1161898225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist