# EL PICC STAT

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** ROBERT L. MCBROOM
- **Other names:** ETTA CAVIN RN
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1902094105
- **Legal business name:** ROBERT L. MCBROOM
- **Authorized official:** MRS. MARY M BROOKING CMOM,CMIS (ADMINISTRATOR)
- **Authorized official phone:** (940) 781-8837

## Contact information

- **Practice address:** 1040 W JEFFERSON ST, BROWNSVILLE, TX 78520-6338
- **Practice address phone:** (940) 781-8837
- **Practice address fax:** (940) 692-4136
- **Mailing address:** 5308 PYRENEES DR, WICHITA FALLS, TX 76310-3949
- **Mailing address phone:** (940) 781-8837
- **Mailing address fax:** (940) 692-4136

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 173000000X | Legal Medicine | F6922 | TX | Yes |

## Other

- **Enumeration date:** 10/12/2007
- **Last updated:** 10/12/2007