Organization
BRENHAM CLINIC ASSN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GRACIE SLATTERY RN (ADMINISTRATOR)
(979) 836-6153
Entity
Organization
Contact information
Practice address
600 N PARK ST, BRENHAM, TX 77833-2610
(979) 836-6153
Mailing address
235 W PALM ST STE 235, BELLVILLE, TX 77418-1372
(979) 836-6153
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
G5283
TX
208000000X
Pediatrics Physician
Primary
E2546
TX
208000000X
Pediatrics Physician
F3730
TX
208000000X
Pediatrics Physician
K6753
TX
Other
Enumeration date
08/25/2006
Last updated
10/27/2007
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