NPIMap

Organization Active NPI

Brooks Surgery Clinic, PLLC

  • Surgery Physician
  • Fort Worth, TX
National Provider Identifier
1083045041
Registry record updated Jan 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
H7704 Issued in TX
Legal business name
BROOKS SURGERY CLINIC, PLLC
Practice address
2260 College Ave
Fort Worth, TX 76110-1952
Phone
(817) 870-0172
Fax
(817) 870-0158
NPI assigned
Dec 2, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 15, 2014

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

Authorized official

Name
Dr. Michael Edwin Brooks, M.D.
Title
Owner
Phone
(817) 870-0172

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X H7704 TX Primary

Addresses

Primary practice location

2260 College Ave
Fort Worth, TX 76110-1952

Mailing address

PO Box 12630
Fort Worth, TX 76110-8630
Phone (817) 870-0172

National Provider Directory

National Provider Directory

Locations

2260 College Ave
Fort Worth, TX 76110
Phone (817) 349-9057

NPI Registry JSON

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

{
    "created_epoch": "1385942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1389744000000",
    "number": "1083045041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12630",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761108630",
            "telephone_number": "817-870-0172",
            "fax_number": "817-870-0158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2260 COLLEGE AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101952",
            "telephone_number": "817-870-0172",
            "fax_number": "817-870-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROOKS SURGERY CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-02",
        "last_updated": "2014-01-15",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "EDWIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-870-0172",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "H7704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2014; 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.