Organization Active NPI

Brazos Lung Association, L.L.P.

  • Pulmonary Disease Physician
  • Bryan, TX
National Provider Identifier
1457579120
Registry record updated May 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
Legal business name
BRAZOS LUNG ASSOCIATION, L.L.P.
Practice address
2700 E 29TH St Ste 260
Bryan, TX 77802
Phone
(979) 774-0012
Fax
(979) 774-4636
NPI assigned
Apr 20, 2007
Last updated
May 29, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 29, 2019

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

Authorized official

Name
Deborah Lynn Cole
Title
Billing
Phone
(979) 774-0012

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X TX
Pulmonary Disease Physician 207RP1001X TX Primary

Addresses

Primary practice location

2700 E 29TH St Ste 260
Bryan, TX 77802

Mailing address

2700 E 29TH St Ste 260
Bryan, TX 77802-2596
Phone (979) 774-0012

Other identifiers 1

IdentifierTypeStateIssuer
083812001MedicaidTX

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1559088000000",
    "number": "1457579120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 E 29TH ST STE 260",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022596",
            "telephone_number": "979-774-0012",
            "fax_number": "979-774-4636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 E 29TH ST STE 260",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "77802",
            "telephone_number": "979-774-0012",
            "fax_number": "979-774-4636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS LUNG ASSOCIATION, L.L.P.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-20",
        "last_updated": "2019-05-29",
        "status": "A",
        "authorized_official_last_name": "COLE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BILLING",
        "authorized_official_telephone_number": "979-774-0012"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "TX",
            "license": null,
            "primary": false
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "083812001",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bryan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 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.