Organization · Type 2 NPI

Brazosport Regional Physician Services

General Practice Physician · Lake Jackson, TX

NPI number 1861795197 Active

Practice location

508 This Way St
Lake Jackson, TX 77566-5128

Call (979) 480-9467 Map

Mailing address

100 Medical Dr
Lake Jackson, TX 77566-5674

Specialties and licenses

Taxonomy	Code	License
General Practice Physician Primary	208D00000X	None listed
Urgent Care Clinic/Center	261QU0200X	None listed

General Practice Physician: A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

3 other providers at this address

NPI record

NPI: 1861795197
Entity type: Organization (Type 2)
Issued: Dec 8, 2010
Last updated: Jan 3, 2011
Status: Active
Subpart: Yes of Brazosport Regional Physician Services

Other names

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Brazosport Regional Urgent Care Center · doing business as

Authorized official

Mr. Daniel Buche
Cheif Executive Officer
(979) 285-1105

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1861795197

Brazosport Regional Physician Services's National Provider Identifier is 1861795197, issued on Dec 8, 2010. The primary taxonomy on file is General Practice Physician (208D00000X), and the practice location is in Lake Jackson, TX. The record was last updated on Jan 3, 2011.