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Organization

MHMRA OF BRAZOS VALLEY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. BILL KELLY (EXECUTIVE DIRECTOR)
(979) 822-6467
Entity
Organization

Contact information

Practice address
804 S TEXAS AVE, BRYAN, TX 77803-3946
(979) 822-6467
(979) 821-9448
Mailing address
1504 TEXAS AVE., BRYAN, TX 77805-1504
(979) 822-6467
(979) 821-9448

Taxonomy

Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
136366501
TX
05
136366502
TX
05
136366504
TX
05
136366505
TX
05
136366506
TX
05
136366507
TX
Enumeration date
06/28/2006
Last updated
03/26/2024
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