MEDICARE: DR. ROSE MARY BROWNRIDGE 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	207R00000X	Internal Medicine Physician	K4868	TX

General Provider Information

NPI Number	:	1902040991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROSE MARY BROWNRIDGE M.D.

Provider Business Mailing Address
First Line	:	1264 TEXAS A&M UNIVERSITY
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77843-0001
Country	:	US
Telephone Number	:	979-458-8300
Fax Number	:	979-458-8314

Provider Business Practice Location Address
First Line	:	1264 TEXAS A&M UNIVERSITY
Second Line	:
City	:	COLLEGE STATION
State	:	TX
Zip	:	77843-0001
Country	:	US
Telephone Number	:	979-458-8300
Fax Number	:	979-458-8314

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

Provider Enumeration Date	:	04/22/2009
Last Update Date	:	04/22/2009

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