Braden, Staci A

Braden, Staci A is an individual health care provider with primary practice located at 2421 Ira E Woods Ave Suite 101, Grapevine TX 76051-3906. She recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as her primary health care specialty. Braden, Staci A can be contacted via phone (817) 410-7773.

Contact Information

Primary practice address
2421 Ira E Woods Ave Suite 101 Grapevine TX 76051-3906
Phone: (817) 410-7773
Fax: (817) 421-5440
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 1148280 Texas

Profile Details

NPI number 1073676102
LBN Legal business name Braden, Staci A
Credentials Physical Therapist (PT)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2006
Last updated Nov 16th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073676102 NPPES
Texas Other 8T7054 BCBS PROVIDER #
Texas Other 1148280 BCBS PROVIDER #

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