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BROOKRIDGE INTERNAL MEDICINE ASSOCIATES PA NPI 1396796553


NPI Information

NPI: 1396796553
Provider Name: BROOKRIDGE INTERNAL MEDICINE ASSOCIATES, PA
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

CLIA Number: 45D0950355

Address:
300 N 3RD ST STE A
LONGVIEW, TX
ZIP 75601
Phone: (903) 315-2907
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BROOKRIDGE INTERNAL MEDICINE ASSOCIATES, PA is a geriatric medicine internal medicine in Longview, TX. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. BROOKRIDGE INTERNAL MEDICINE ASSOCIATES, PA NPI is 1396796553. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

300 N 3RD ST STE A
LONGVIEW, TX
ZIP 75601
Phone: (903) 315-2907
Fax: (903) 315-2927

The provider's authorized official is Brenda M Vozza .
The authorized official title is Owner and has the following contact phone number (903) 315-2907.

The CLIA number assigned to this NPI record is 45D0950355 - physician office with a certificate type of Certificate of Compliance.

The enumeration date for this NPI number is 5/13/2006 and was last updated on 1/13/2020.


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
1207RG0300XInternal MedicineGeriatric MedicineK6399TEXASYes

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
1161382002MEDICAIDTEXAS

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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