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Ms. Braelen Dawn Ivicevich, PA-C
Surgical Physician Assistant in Houston, Texas
NPI 1568834893

Braelen Dawn Ivicevich is a Surgical Physician Assistant based in Houston, TX and is specialized in Surgical. Braelen Dawn Ivicevich practices in Houston, TX and has the professional credentials of PA-C. The NPI Number for Braelen Dawn Ivicevich is 1568834893 and holds a License No. (Texas).

The current practice location address for Braelen Dawn Ivicevich is 6560 Fannin, Houston, TX and can be reached out via phone at 281-737-4560 and via fax at 281-737-4561.

Location: 6560 Fannin, Houston, TX, 77030
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Provider Profile Details
NPI Number
1568834893
Provider Name
Braelen Dawn Ivicevich
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
6560 Fannin, Houston, TX, 77030
Phone Number
281-737-4560
Fax Number
281-737-4561
Provider Enumeration Date
10/26/2015
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8266NT 01 TX BLUE CROSS BLUE SHIELD
1568834893 01 NPI
institution
Provider Business Practice Location Address Details
Address
6560 Fannin
City
State
Zip
77030
Phone Number
281-737-4560
Fax Number
281-737-4561
person
Provider Business Mailing Address Details
Address
6560 Fannin
City
State
Zip
77030
Phone Number
281-737-4560
Fax Number
281-737-4561
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
(Texas)
Definition
Definition to come...
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