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General NPI Number Information
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NPI Number | 1831628874
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Entity Type | Organization
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Legal Business Name | BROOKHOLLOW OB & GYN CLINIC, PLLC
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Dates
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Enumeration Date | 06/04/2017
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Last Update Date | 05/14/2021
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Provider Practice Location Address
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Address Line | 14990 NORTHWEST FWY
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City | HOUSTON
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State | TX
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Zip | 77040-4025
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Country | US
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Telephone | 832-230-1803
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Fax | 832-240-3402
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Provider Business Mailing Address
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Address Line | 14990 NORTHWEST FWY
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City | HOUSTON
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State | TX
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Zip | 77040-4025
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Country | US
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Telephone | 832-230-1803
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Fax | 832-240-3402
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Authorized Official
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Title or Position | HEAD NURSE
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Name | MARIA D J AVALOS
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Credential |
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Telephone | 832-622-2059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 7526
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License Number State | TX
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