Active NPI
Kristina Medhus Braly, M.D.
- Anesthesiology Physician
- Houston, TX
National Provider Identifier
1164778817
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- R2817
- Practice address
- 1500 Citywest Blvd Ste 300
Houston, TX 77042-2549 - Phone
- (713) 620-4000
- NPI assigned
- Jul 31, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 2016-01049 | NC | |
| Pain Medicine (Anesthesiology) Physician | 207LP2900X | 2016-01049 | NC | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Anesthesiology Physician | 207L00000X | R2817 | TX | Primary |
Addresses
Primary practice location
1500 Citywest Blvd Ste 300
Houston, TX 77042-2549
Mailing address
PO Box 840853
Dallas, TX 75284-0865
Phone (972) 233-1999
Other practice location 1
1638 Owen Dr
Fayetteville, NC 28304-3424
Phone (910) 323-1313
Other names 1
- Kristina Medhus Braly
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R2817 | TX | MD | Anesthesiology Physician |
| 2016-01049 | NC | MD | Pain Medicine (Anesthesiology) Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1343692800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598227200000",
"number": "1164778817",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 840853",
"city": "DALLAS",
"state": "TX",
"postal_code": "752840865",
"telephone_number": "972-233-1999",
"fax_number": "972-233-3666"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1500 CITYWEST BLVD STE 300",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770422549",
"telephone_number": "713-620-4000"
}
],
"practiceLocations": [
{
"address_1": "1638 Owen Dr",
"address_purpose": "LOCATION",
"city": "Fayetteville",
"state": "NC",
"postal_code": "283043424",
"country_code": "US",
"telephone_number": "910-323-1313",
"fax_number": "910-323-5798",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BRALY",
"first_name": "KRISTINA",
"middle_name": "MEDHUS",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-31",
"last_updated": "2020-08-24",
"certification_date": "2020-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "NC",
"license": "2016-01049",
"primary": false
},
{
"code": "207LP2900X",
"taxonomy_group": "",
"desc": "Anesthesiology, Pain Medicine",
"state": "NC",
"license": "2016-01049",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "TX",
"license": "R2817",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTINA",
"last_name": "BRALY",
"middle_name": "MEDHUS",
"credential": "MD",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.