Healthcare Provider Details

I. General information

NPI: 1811229073
Provider Name (Legal Business Name): BPM ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2010
Last Update Date: 02/12/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 N BROOKS ST
BRAZORIA TX
77422-8718
US

IV. Provider business mailing address

PO BOX 1235
BRAZORIA TX
77422-1235
US

V. Phone/Fax

Practice location:
  • Phone: 979-798-9103
  • Fax: 979-798-9109
Mailing address:
  • Phone: 979-798-9103
  • Fax: 979-798-9109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number10723
License Number StateTX

VIII. Authorized Official

Name: MRS. BERNICE PARKER MCCANN
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 979-798-9103