Individual
BRENT MOTHNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6621 FANNIN ST, HOUSTON, TX 77030-2303
(832) 824-5497
(832) 825-5424
Mailing address
6621 FANNIN ST, HOUSTON, TX 77030-2303
(832) 824-5497
(832) 825-5424
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
M1249
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
174478102
—
TX
Enumeration date
10/17/2006
Last updated
03/30/2011
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