Organization
BRAZOS VALLEY EMERGENCY PHYSICIANS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM ROBERTS MD (PRESIDENT)
(512) 452-8533
Entity
Organization
Contact information
Practice address
210 S JUDSON ST, NAVASOTA, TX 77868-3704
(844) 474-4019
Mailing address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(844) 474-4019
(330) 493-0867
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0038KZ
BCBS
TX
05
—
166018502
—
TX
01
—
166018503
CSHCN
TX
Enumeration date
06/03/2006
Last updated
02/18/2024
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