Organization
BRENHAM FAMILY PRACTICE AND OBSTETRICS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JON F BODE MD (OWNER)
(979) 836-2822
Entity
Organization
Contact information
Practice address
601 MEDICAL PKWY, STE D, BRENHAM, TX 77833-5429
(979) 836-2822
(979) 836-1943
Mailing address
601 MEDICAL PKWY, STE D, BRENHAM, TX 77833-5429
(979) 836-2822
(979) 836-1943
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207VX0000X
Obstetrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00159U
BCBS
—
05
—
157272901
—
TX
01
—
157272902
EPSDT
TX
Enumeration date
10/11/2005
Last updated
04/20/2021
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