MEDICARE: BRAZOS VALLEY MEDICAL PRACTICE, PA

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103T00000X	Psychologist
3	103TC1900X	Counseling Psychologist
4	2084P0800X	Psychiatry Physician
5	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1831045608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRAZOS VALLEY MEDICAL PRACTICE, PA

Provider Business Mailing Address
First Line	:	316 W 12TH ST FL 4
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1815
Country	:	US
Telephone Number	:	737-707-4569
Fax Number	:

Provider Business Practice Location Address
First Line	:	316 W 12TH ST FL 4
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78701-1815
Country	:	US
Telephone Number	:	737-707-4569
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	JONATHAN SNIPES
Credential	:	MD
Telephone Number	:	213-827-3038

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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Directions to “BRAZOS VALLEY MEDICAL PRACTICE, PA ” Practice Location

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