Organization
BROOKS SURGERY CLINIC, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL EDWIN BROOKS M.D. (OWNER)
(817) 870-0172
Entity
Organization
Contact information
Practice address
2260 COLLEGE AVE, FORT WORTH, TX 76110-1952
(817) 870-0172
(817) 870-0158
Mailing address
PO BOX 12630, FORT WORTH, TX 76110-8630
(817) 870-0172
(817) 870-0158
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
H7704
TX
Other
Enumeration date
12/02/2013
Last updated
01/15/2014
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