Organization
BRAZOSPORT HEALTH ALLIANCE
Active
Parent organization
BRAZOSPORT REGIONAL HEALTH SYSTEM
Organization subpart
Yes
Provider details
NPI number
Legal business name
BRAZOSPORT REGIONAL HEALTH SYSTEM
Authorized official
MS. DEBBIE THEVENET (ADMINISTRATOR)
(979) 299-1210
Entity
Organization
Contact information
Practice address
129 CIRCLE WAY ST, SUITE A, LAKE JACKSON, TX 77566-5249
(979) 299-1210
Mailing address
129 CIRCLE WAY ST, SUITE A, LAKE JACKSON, TX 77566-5249
(979) 299-1210
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
—
—
Other
Enumeration date
03/16/2009
Last updated
03/16/2009
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