Organization
BRENHAM CLINIC ASSOCIATION PA
Active
Organization
BRENHAM CLINIC ASSOCIATION PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACIE SLATTERY (ADMINISTRATOR)
(979) 836-6153
Entity
Organization
Contact information
Practice address
235 WEST PALM, STE 106, BELLVILLE, TX 77418-1372
(979) 836-6153
Mailing address
600 NORTH PARK, BRENHAM, TX 77833-2610
(979) 836-6153
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G5283
TX
207R00000X
Internal Medicine Physician
E8650
TX
207R00000X
Internal Medicine Physician
Primary
F4241
TX
207R00000X
Internal Medicine Physician
M8802
TX
207V00000X
Obstetrics & Gynecology Physician
H0692
TX
207V00000X
Obstetrics & Gynecology Physician
M4810
TX
208000000X
Pediatrics Physician
E2546
TX
208000000X
Pediatrics Physician
F3730
TX
208000000X
Pediatrics Physician
K6753
TX
208000000X
Pediatrics Physician
N1685
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137248411
—
TX
Enumeration date
08/19/2006
Last updated
12/11/2009
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