MEDICARE: DR. AMY E. BREWER M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	19302	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	K8028	OTHER	TX	TSBME

General Provider Information

NPI Number	:	1427169747
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AMY E. BREWER M.D.

Provider Business Mailing Address
First Line	:	1031 SUMMER FIELD CIR
Second Line	:
City	:	MC GREGOR
State	:	TX
Zip	:	76657-3458
Country	:	US
Telephone Number	:	254-845-4334
Fax Number	:	888-807-1573

Provider Business Practice Location Address
First Line	:	1031 SUMMER FIELD CIR
Second Line	:
City	:	MC GREGOR
State	:	TX
Zip	:	76657-3458
Country	:	US
Telephone Number	:	254-845-4334
Fax Number	:	888-807-1573

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	06/03/2014

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