Breazeale, Nathan
Breazeale, Nathan is an individual health care provider with primary practice located at 900 W 38Th St Suite 300, Austin TX 78705-1130. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Breazeale, Nathan can be contacted via phone (512) 450-1300.Contact Information
Primary practice address
900 W 38Th St Suite 300
Austin TX 78705-1130
Phone: (512) 450-1300
Fax: (512) 450-1339
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207XX0005X | J1500 | Texas |
Profile Details
| NPI number | 1194795062 |
|---|---|
| LBN Legal business name | Breazeale, Nathan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Feb 3rd, 2011 - about 14 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194795062 | NPPES |
| Texas | MEDICAID | 102491102 | |
| Texas | Other | 1278600001 |
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