Organization
BRENHAM FAMILY CARE, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. EDNA M BUSTOS (OFFICE ADMINISTRATION)
(979) 830-1441
Entity
Organization
Contact information
Practice address
605 MEDICAL CT STE 201, BRENHAM, TX 77833-5406
(979) 830-1441
(979) 830-1369
Mailing address
605 MEDICAL CT STE 201, BRENHAM, TX 77833-5406
(979) 830-1441
(979) 830-1369
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
525996
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062LC
BCBS
TX
05
—
165150701
—
TX
Enumeration date
02/12/2007
Last updated
06/08/2009
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