Brazosport Ear, Nose & Throat Clinic, PA

Primary specialty

SpecialistTaxonomy code 174400000X

License

F1152 Issued in TX

Legal business name

BRAZOSPORT EAR, NOSE & THROAT CLINIC, PA

Practice address

201 Oak Dr S
Suite 207
Lake Jackson, TX 77566-5676

Phone

(979) 297-2477

NPI assigned

Nov 10, 2005

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Bruce Paul Meyers, MD

Title

President

Phone

(979) 297-2477

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1131580800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1013998673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 OAK DR S",
            "address_2": "SUITE 207",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665676",
            "telephone_number": "979-297-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 OAK DR S",
            "address_2": "SUITE 207",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775665676",
            "telephone_number": "979-297-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOSPORT EAR, NOSE & THROAT CLINIC, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-10",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MEYERS",
        "authorized_official_first_name": "BRUCE",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "979-297-2477",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "TX",
            "license": "F1152",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brazos Primary Care Associates
• Brazos River Emergency Physicians PLLC
• Brazosport Cardiology, P.a. (Pearland Heart Institute)
• Brazosport Clinical Lab
• Brazosport Dermatology Clinic PA
• Brazosport Eye Facility, Inc. (Brazosport Eye Institute)
• Brazosport Health Alliance
• Brazosport Health Alliance
• Brazosport Pediatric Clinic, P.a.
• Brazosport Professional Eye Clinic Inc (Mark A Provenzano OD)

• Specialist in Lake Jackson, TX
• Providers in Lake Jackson, TX by specialty
• Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.