MEDICARE: DR. JORGE R BROTHERS M.D.

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	208800000X	Urology Physician	H1048	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841232923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORGE R BROTHERS M.D.

Provider Business Mailing Address
First Line	:	418 N UTICA AVE
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79416-3035
Country	:	US
Telephone Number	:	806-771-5882
Fax Number	:	806-687-9002

Provider Business Practice Location Address
First Line	:	418 N UTICA AVE
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79416-3035
Country	:	US
Telephone Number	:	806-771-5882
Fax Number	:	806-687-9002

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

Provider Enumeration Date	:	06/12/2006
Last Update Date	:	10/30/2024

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