Healthcare Provider Details

I. General information

NPI: 1235296682
Provider Name (Legal Business Name): BROOKSHIRE BROS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/03/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1906 N FRAZIER ST STE B
CONROE TX
77301-1240
US

IV. Provider business mailing address

1906 N FRAZIER ST STE B
CONROE TX
77301-1240
US

V. Phone/Fax

Practice location:
  • Phone: 936-539-6521
  • Fax: 936-539-6523
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number25265
License Number StateTX

VIII. Authorized Official

Name: JERRY JOHNSON
Title or Position: EXEC VP
Credential: CPHT
Phone: 936-634-8155