Healthcare Provider Details

I. General information

NPI: 1528590726
Provider Name (Legal Business Name): BROOKE ANN THIGPEN M. D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2017
Last Update Date: 05/15/2023
Certification Date: 05/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6651 MAIN ST STE 1020
HOUSTON TX
77030-2351
US

IV. Provider business mailing address

316 N LOMBARDY LOOP
JACKSONVILLE FL
32259-5266
US

V. Phone/Fax

Practice location:
  • Phone: 832-826-7464
  • Fax:
Mailing address:
  • Phone: 904-635-3970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberT0953
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: