Active NPI
Russell Joseph Brofer, D.O.
- Family Medicine Physician
- Arlington, TX
National Provider Identifier
1477797017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- K2856
- Practice address
- 5405 S Cooper St
Arlington, TX 76017-6148 - Phone
- (817) 465-4928
- Fax
- (817) 472-0758
- NPI assigned
- Apr 27, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | K2856 | TX | Primary |
Addresses
Primary practice location
5405 S Cooper St
Arlington, TX 76017-6148
Mailing address
PO Box 9101
Coppell, TX 75019-9494
Phone (972) 745-7500
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)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K2856 | TX | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Primary Health Physicians, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Urgent Care Clinic/Center
- Denton, TX
- NPI 1770048704
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1240790400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1346976000000",
"number": "1477797017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 9101",
"city": "COPPELL",
"state": "TX",
"postal_code": "750199494",
"telephone_number": "972-745-7500",
"fax_number": "972-745-4376"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5405 S COOPER ST",
"city": "ARLINGTON",
"state": "TX",
"postal_code": "760176148",
"telephone_number": "817-465-4928",
"fax_number": "817-472-0758"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROFER",
"first_name": "RUSSELL",
"middle_name": "JOSEPH",
"credential": "D.O.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-04-27",
"last_updated": "2012-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "K2856",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.