MEDICARE: DR. JESSICA BROOKS ANDERSON MD

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	207R00000X	Internal Medicine Physician	M8492	TX
2	208000000X	Pediatrics Physician	M8492	TX

General Provider Information

NPI Number	:	1881885069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JESSICA BROOKS ANDERSON MD

Provider Business Mailing Address
First Line	:	2255 E MOSSY OAKS RD STE 680
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-1812
Country	:	US
Telephone Number	:	281-537-0300
Fax Number	:	281-537-0315

Provider Business Practice Location Address
First Line	:	2255 E MOSSY OAKS RD STE 680
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77389-1812
Country	:	US
Telephone Number	:	281-537-0300
Fax Number	:	281-537-3015

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

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	12/11/2019

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