Healthcare Provider Details

I. General information

NPI: 1528165594
Provider Name (Legal Business Name): RALPH HAMILTON BROOKSHIRE III DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 08/28/2025
Certification Date: 08/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2511 CORNERSTONE BLVD STE 2511
EDINBURG TX
78539-8463
US

IV. Provider business mailing address

PO BOX 4199
MCALLEN TX
78502-4199
US

V. Phone/Fax

Practice location:
  • Phone: 956-322-7662
  • Fax: 956-338-5709
Mailing address:
  • Phone: 956-322-7662
  • Fax: 956-338-5709

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberL9113
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberL9113
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: