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1689651986

NPI Code Detail

MEDICARE: MRS. RHODABECA R BROOKS PA

MEDICARE: MRS. RHODABECA R BROOKS 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	363A00000X	Physician Assistant	PA00774	OR
2	363AM0700X	Medical Physician Assistant	PA07031	TX
3	363AM0700X	Medical Physician Assistant	PA10003761	WA
4	363A00000X	Physician Assistant	PA07031	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3929BR	OTHER	WA	REGENCE RIDER NUMBER
2	1275726853	OTHER	TX	COLLEGE STATION/ABC
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	1821185299	OTHER	TX	AGENCY NPI
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	0220759	OTHER	WA	LABOR AND INDUSTRIES

General Provider Information

NPI Number	:	1689651986
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RHODABECA R BROOKS PA

Provider Business Mailing Address
First Line	:	PO BOX 844658
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75284-4658
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 UNIVERSITY DR E
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77840-2661
Country	:	US
Telephone Number	:	979-691-3300
Fax Number	:	979-691-3527

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	07/30/2024

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Directions to “ MRS. RHODABECA R BROOKS PA” 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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