Basic Information
| Provider Information | |||||||||
| NPI: | 1003010703 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BRINDLEY | ||||||||
| FirstName: | MACE | ||||||||
| MiddleName: | BENJAMIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 601 W HWY 6 STE 106 | ||||||||
| Address2: | |||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767105592 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547767744 | ||||||||
| FaxNumber: | 2547519211 | ||||||||
| Practice Location | |||||||||
| Address1: | 601 W HWY 6 STE 106 | ||||||||
| Address2: | |||||||||
| City: | WACO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 767105592 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2547767744 | ||||||||
| FaxNumber: | 2547519211 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/14/2007 | ||||||||
| LastUpdateDate: | 11/20/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/20/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207YP0228X | M8557 | TX | N | Allopathic & Osteopathic Physicians | Otolaryngology | Pediatric Otolaryngology | 207YS0012X | M8557 | TX | N | Allopathic & Osteopathic Physicians | Otolaryngology | Sleep Medicine | 207Y00000X | M8557 | TX | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.