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General NPI Number Information
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NPI Number | 1003834599
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Entity Type | Individual
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Provider Name | MARK BROOKS PA-C
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Gender | Male
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 17903 W LAKE HOUSTON PKWY STE 201
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City | HUMBLE
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State | TX
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Zip | 77346-3954
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Country | US
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Telephone | 281-446-7173
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Fax | 832-644-5615
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Provider Business Mailing Address
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Address Line | 1702 FM 1960 BYPASS RD E
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City | HUMBLE
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State | TX
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Zip | 77338-3916
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Country | US
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Telephone | 281-446-7173
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Fax | 832-644-5615
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA03324
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License Number State | TX
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