Lucas Brolley

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

Practice address

2129 Branchwood Dr
Grapevine, TX 76051-7822

Phone

(817) 471-8672

NPI assigned

Apr 28, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1493337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493337600000",
    "number": "1629503529",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2129 BRANCHWOOD DR",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760517822"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2129 BRANCHWOOD DR",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760517822",
            "telephone_number": "817-471-8672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROLLEY",
        "first_name": "LUCAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-28",
        "last_updated": "2017-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brennan Riche D.C.
• Lisa Brennan, LPC
• Brent W. Bost, MD, PA
• Arika Bright, RBT
• Michael Ryan Briseno, M.D.
• Brooks Trotter M.D. P.a.
• Donny Lynn Brooks, MA
• Abigail Irene Brown
• Carmen L Brown, LP, LSSP
• Kelly M Brown, DC

• All providers in Grapevine, TX
• Athletic Trainer in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.