Organization
BRAZOS MEDICAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN M SADTLER (OFFICE MANAGER)
(979) 764-4043
Entity
Organization
Contact information
Practice address
1602 ROCK PRAIRIE RD, SUITE 3000, COLLEGE STATION, TX 77845-8306
(979) 764-4043
(979) 694-2175
Mailing address
1602 ROCK PRAIRIE RD, SUITE 3000, COLLEGE STATION, TX 77845-8306
(979) 764-4043
(979) 694-2175
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G0919
TX
207Q00000X
Family Medicine Physician
L9919
TX
207V00000X
Obstetrics & Gynecology Physician
Primary
G1054
TX
207V00000X
Obstetrics & Gynecology Physician
L3243
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00PM97
BLUE CROSS BLUE SHIELD OF TEXAS
TX
05
—
084493801
—
TX
01
—
CH8669
MEDICARE RAILROAD
TX
Enumeration date
07/08/2006
Last updated
09/15/2008
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