# FAMILY PRACTICE FOUNDATION OF THE BRAZOS VALLEY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** FAMILY PRACTICE FOUNDATION OF THE BRAZOS VALLEY
- **Other names:** Family Medicine Center & Brazos Family Medicine Residency
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1578573531
- **Legal business name:** FAMILY PRACTICE FOUNDATION OF THE BRAZOS VALLEY
- **Authorized official:** DR. DAVID A MCCLELLAN M.D. (PROGRAM DIRECTOR)
- **Authorized official phone:** (979) 862-4465

## Contact information

- **Practice address:** 1301 MEMORIAL DRIVE, SUITE 200, BRYAN, TX 77802-5201
- **Practice address phone:** (979) 862-4465
- **Practice address fax:** (979) 774-6603
- **Mailing address:** 1301 MEMORIAL DRIVE, SUITE 200, BRYAN, TX 77802-5201
- **Mailing address phone:** (979) 862-4465
- **Mailing address fax:** (979) 774-6603

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | M2390 | TX | Yes |

## Other

- **Enumeration date:** 08/09/2006
- **Last updated:** 08/05/2008