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Organization

BRAZOSPORT REGIONAL PHYSICIAN SERVICES

Active
Parent organization
BRAZOSPORT REGIONAL PHYSICIAN SERVICES
Other names
Brazosport Regional Urgent Care Center
Organization subpart
Yes

Provider details

NPI number
Legal business name
BRAZOSPORT REGIONAL PHYSICIAN SERVICES
Authorized official
MR. DANIEL BUCHE (CHEIF EXECUTIVE OFFICER)
(979) 285-1105
Entity
Organization

Contact information

Practice address
508 THIS WAY ST, LAKE JACKSON, TX 77566-5128
(979) 480-9467
Mailing address
100 MEDICAL DR, LAKE JACKSON, TX 77566-5674
(979) 285-1105

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
261QU0200X
Urgent Care Clinic/Center
TX

Other

Enumeration date
12/08/2010
Last updated
01/03/2011
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