MEDICARE: BRAZOS EMERGENCY PHYSICIANS, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician

General Provider Information

NPI Number	:	1205948635
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAZOS EMERGENCY PHYSICIANS, PA

Provider Business Mailing Address
First Line	:	PO BOX 27797
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77227-7797
Country	:	US
Telephone Number	:	713-470-6006
Fax Number	:

Provider Business Practice Location Address
First Line	:	2425 WEST LOOP S
Second Line	:	SUITE 601
City	:	HOUSTON
State	:	TX
Zip	:	77027-4205
Country	:	US
Telephone Number	:	713-470-6006
Fax Number	:

Authorized Official
Title or Position	:	A/R MANAGER
Name	:	CHRIS MORALES
Credential	:
Telephone Number	:	713-470-6048

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	02/11/2008

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