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BRAZOSPORT COMMUNITY MEDICAL CLINIC NPI 1881649747


NPI Information

NPI: 1881649747
Provider Name: BRAZOSPORT COMMUNITY MEDICAL CLINIC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
606 N GULF BLVD
FREEPORT, TX
ZIP 77541
Phone: (979) 871-9453
Get Directions

BRAZOSPORT COMMUNITY MEDICAL CLINIC is a family medicine in Freeport, TX. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BRAZOSPORT COMMUNITY MEDICAL CLINIC NPI is 1881649747. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

606 N GULF BLVD
FREEPORT, TX
ZIP 77541-902
Phone: (979) 871-9453
Fax: (979) 871-9429

The provider's authorized official is Inyang E Wilson .
The authorized official title is Ceo/pa and has the following contact phone number (979) 871-9453.

The enumeration date for this NPI number is 5/22/2006 and was last updated on 5/4/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicinePA00933TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
100869UMEDICARE PINTEXAS
2E55253MEDICARE UPINTEXAS
3162136901MEDICAIDTEXAS
4P14150MEDICARE UPINTEXAS
5138038816MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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