Organization
DALE W BROCK
Active
Other names
Trinity Valley Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DALE W BROCK APN (OWNER)
(936) 336-3100
Entity
Organization
Contact information
Practice address
2800 BEAUMONT AVE, SUITE A, LIBERTY, TX 77575-5126
(936) 336-3100
(936) 336-3102
Mailing address
2800 BEAUMONT AVE, SUITE A, LIBERTY, TX 77575-5126
(936) 336-3100
(936) 336-3102
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
603165
TX
Other
Enumeration date
05/23/2016
Last updated
05/23/2016
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