Individual
MR. BOBBY CHARLES BROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
66 GRUENE PARK DR STE 205, NEW BRAUNFELS, TX 78130
(830) 743-9192
(830) 743-9193
Mailing address
8711 VILLAGE DR STE 114, SAN ANTONIO, TX 78217-5419
(830) 743-9192
(830) 743-9193
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H5753
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
139144317
—
TX
01
—
H5753
TX LICENSE
TX
01
—
PO1477395
RR MEDICARE
TX
Enumeration date
09/16/2006
Last updated
05/30/2018
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