Healthcare Provider Details

I. General information

NPI: 1386577468
Provider Name (Legal Business Name): BRAZOS VALLEY CARDIOLOGY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6818 STEEP HOLLOW CIR
BRYAN TX
77808-5120
US

IV. Provider business mailing address

6818 STEEP HOLLOW CIR
BRYAN TX
77808-5120
US

V. Phone/Fax

Practice location:
  • Phone: 214-995-0774
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: CHARLES HOWARD
Title or Position: MEMBER
Credential: MD
Phone: 214-995-0774