Healthcare Provider Details

I. General information

NPI: 1386861300
Provider Name (Legal Business Name): JOSEPH GARNETT BROOKS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2200 WEST ILLINOIS AVENUE
MIDLAND TX
79701
US

IV. Provider business mailing address

3119 MCCOMAS AVENUE
KENSINGTON MD
20895
US

V. Phone/Fax

Practice location:
  • Phone: 432-685-1111
  • Fax:
Mailing address:
  • Phone: 301-949-1181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberL3251
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: