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General NPI Number Information
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NPI Number | 1093930562
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Entity Type | Individual
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Provider Name | KENNETH RYAN BROOKS M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 01/21/2026
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Provider Practice Location Address
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Address Line | 905 W MEDICAL CENTER BLVD STE 404
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City | WEBSTER
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State | TX
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Zip | 77598-4009
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Country | US
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Telephone | 281-985-9342
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Fax | 281-393-0029
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Provider Business Mailing Address
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Address Line | PO BOX 58538
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City | WEBSTER
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State | TX
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Zip | 77598-8538
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Country | US
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Telephone | 281-985-9342
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Fax | 281-393-0029
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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 | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | N3515
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | N3515
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 4301088759
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 4301088759
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License Number State | MI
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Taxonomy #5
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | N3515
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License Number State | TX
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