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NPI Code Detail

MEDICARE: BROOKSIDE HEALTH INITIATIVES

MEDICARE: BROOKSIDE HEALTH INITIATIVES
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
1174400000XSpecialist
2261QF0050XNon-Surgical Family Planning Clinic/Center

General Provider Information

NPI Number : 1366224065
Entity Type Code : Organization
Provider Name (Legal Business Name) : BROOKSIDE HEALTH INITIATIVES
Provider Business Mailing Address
First Line : 1902 S IH 35
Second Line :
City : AUSTIN
State : TX
Zip : 78704-3628
Country : US
Telephone Number : 512-443-9595
Fax Number : 512-443-7077
Provider Business Practice Location Address
First Line : 1902 S IH 35
Second Line :
City : AUSTIN
State : TX
Zip : 78704-3628
Country : US
Telephone Number : 512-443-9595
Fax Number : 512-443-7077
Authorized Official
Title or Position : DIRECTOR
Name : LENDOL L DAVIS
Credential : MD
Telephone Number : 512-443-9595
Provider Enumeration Date : 10/17/2023
Last Update Date : 11/03/2023

Similar Medicare Providers

1255336855 — LENDOL L. 'TAD' DAVIS M.D.
Practice Location Address:
1902 S IH 35
AUSTIN, TX
78704-3628
Practice Phone: 512-443-9595
Practice Fax:
1104896729 — ANDREW E MASSMAN M.D.
Practice Location Address:
1902 S IH 35
AUSTIN, TX
78704-3628
Practice Phone: 512-443-9595
Practice Fax:
1568524148 — MRS. VIRGINIA KATHRYN RIDOUT APN
Practice Location Address:
1902 S I H 35
AUSTIN, TX
78704-3628
Practice Phone: 512-443-9595
Practice Fax:
1316004674 — BROOKSIDE WOMENS MEDICAL CENTER
Practice Location Address:
1902 S I H 35
AUSTIN, TX
78704-3628
Practice Phone: 512-443-9595
Practice Fax:
1740336171 — BROOKSIDE WOMENS MEDICAL SERVICES, PA
Practice Location Address:
1902 S I H 35
AUSTIN, TX
78704-3628
Practice Phone: 512-443-9595
Practice Fax:
1356314884 — JILL TERI BUBEL P.T.
Practice Location Address:
2 AUSTIN CT
POUGHKEEPSIE, NY
12603-3628
Practice Phone: 845-471-3017
Practice Fax: 845-471-3073

Directions to “BROOKSIDE HEALTH INITIATIVES ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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