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General NPI Number Information
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NPI Number | 1972581940
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Entity Type | Organization
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Legal Business Name | THE COMMUNITY HOSPITAL OF BRAZOSPORT
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Dates
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Enumeration Date | 01/09/2006
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Last Update Date | 03/13/2024
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Provider Practice Location Address
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Address Line | 100 MEDICAL DR
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City | LAKE JACKSON
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State | TX
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Zip | 77566
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Country | US
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Telephone | 979-297-4411
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Fax | 979-285-1730
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Provider Business Mailing Address
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Address Line | 100 MEDICAL DR
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City | LAKE JACKSON
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State | TX
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Zip | 77566
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Country | US
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Telephone | 979-297-4411
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Fax | 979-285-1730
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. ROBERT TRAUTMAN
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Credential |
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Telephone | 979-285-1802
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 000436
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License Number State | TX
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