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Individual
TERA C BROOKS
Active
Individual
TERA C BROOKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R8322
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27439
NEBRASKA STATE LICENSE
NE
05
—
388879401
—
TX
05
—
388879402
—
TX
Enumeration date
03/07/2012
Last updated
11/06/2018
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