Provider Demographics
NPI:1861432890
Name:BREHM, DAVID (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:BREHM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6190 LBJ FRWY
Mailing Address - Street 2:STE 800
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6348
Mailing Address - Country:US
Mailing Address - Phone:972-851-0055
Mailing Address - Fax:972-851-0066
Practice Address - Street 1:6190 LBJ FRWY
Practice Address - Street 2:STE 800
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6348
Practice Address - Country:US
Practice Address - Phone:972-851-0055
Practice Address - Fax:972-851-0066
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2011-03-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXL0762207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX752889871OtherTAX ID NUMBER
TX143748501Medicare ID - Type Unspecified
TX00211MMedicare ID - Type Unspecified
TXH26110Medicare UPIN