Organization
BRENHAM CLINIC ASSN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACIE SLATTERY (ADMINISTRATOR)
(979) 836-6153
Entity
Organization
Contact information
Practice address
600 NORTH PARK ST, BRENHAM, TX 77833-2610
(979) 836-6153
Mailing address
600 NORTH PARK ST, BRENHAM, TX 77833-2610
(979) 836-6153
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D0498452
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
137248412
—
TX
Enumeration date
07/28/2006
Last updated
08/11/2009
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