Individual provider Active NPI

Kathleen Lawlor Brooks, MD

  • Family Medicine Physician
  • Azle, TX
National Provider Identifier
1407968894
Registry record updated Sep 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
J6350 Issued in TX
Practice address
413 W Main St
Azle, TX 76020-2905
Phone
(817) 444-9001
Fax
(817) 444-9958
NPI assigned
Aug 31, 2006
Last updated
Sep 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2019

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

Specialties & licenses 11

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 141700 CA
Family Medicine Physician 207Q00000X 51654 AZ
Family Medicine Physician 207Q00000X 60689 MN
Family Medicine Physician 207Q00000X MD175681 OR
Family Medicine Physician 207Q00000X 24520 MS
Family Medicine Physician 207Q00000X 303427 LA
Family Medicine Physician 207Q00000X MD.35205 AL
Family Medicine Physician 207Q00000X 036141129 IL
Family Medicine Physician 207Q00000X MD60621771 WA
Family Medicine Physician 207Q00000X DR.0057708 CO
Family Medicine Physician 207Q00000X J6350 TX Primary

Addresses

Primary practice location

413 W Main St
Azle, TX 76020-2905

Mailing address

413 W Main St
Azle, TX 76020-2905
Phone (817) 444-9001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
141700CAMDMarriage & Family Therapist
DR.0057708COMDFamily Medicine Physician
303427LAMDFamily Medicine Physician
60689MNMDFamily Medicine Physician
24520MSMDFamily Medicine Physician
J6350TXMDFamily Medicine Physician
MD60621771WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians and Allied Health Professionals Group, PA Family Medicine Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568332800000",
    "number": "1407968894",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 W MAIN ST",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760202905",
            "telephone_number": "817-444-9001",
            "fax_number": "817-444-9958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 W MAIN ST",
            "city": "AZLE",
            "state": "TX",
            "postal_code": "760202905",
            "telephone_number": "817-444-9001",
            "fax_number": "817-444-9958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKS",
        "first_name": "KATHLEEN",
        "middle_name": "LAWLOR",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2019-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "141700",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AZ",
            "license": "51654",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "60689",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "MD175681",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "24520",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "303427",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "AL",
            "license": "MD.35205",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036141129",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "MD60621771",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CO",
            "license": "DR.0057708",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "J6350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Azle, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2019; 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.