Basic Information
Provider Information
NPI: 1003010703
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BRINDLEY
FirstName: MACE
MiddleName: BENJAMIN
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 4510 MEDICAL CENTER DR
Address2: SUITE 100
City: MCKINNEY
State: TX
PostalCode: 750691650
CountryCode: US
TelephoneNumber: 9729841050
FaxNumber: 9729841376
Practice Location
Address1: 4510 MEDICAL CENTER DR
Address2: SUITE 100
City: MCKINNEY
State: TX
PostalCode: 750691650
CountryCode: US
TelephoneNumber: 9729841050
FaxNumber: 9729841376
Other Information
ProviderEnumerationDate: 06/14/2007
LastUpdateDate: 01/10/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Y00000XM8557TXY Allopathic & Osteopathic PhysiciansOtolaryngology 
207YP0228XM8557TXN Allopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
207YS0012XM8557TXN Allopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine

No ID Information.


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