Individual provider Active NPI

Brenna Marie Parker, MD

  • Pediatrics Physician
  • Portland, TX
National Provider Identifier
1457938524
Registry record updated Aug 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
V0501 Issued in TX
Practice address
277 Buddy Ganem Dr Ste a
Portland, TX 78374-3202
Phone
(361) 777-3900
NPI assigned
Mar 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X V0501 TX Primary

Addresses

Primary practice location

277 Buddy Ganem Dr Ste a
Portland, TX 78374-3202

Mailing address

277 Buddy Ganem Dr Ste a
Portland, TX 78374-3202
Phone (361) 777-3900

Other practice location 1

1227 Enrique M Barrera Pkwy
San Antonio, TX 78227-2210
Phone (210) 538-8386

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
V0501TXMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Almouie Pediatrics Pediatrics PastSince Jun 1, 2024 Accepting new patients
Topcare Medical Group Inc PastSince Jun 1, 2024 Accepting new patients

Organizations & group practices 2

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": "1616630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724025600000",
    "number": "1457938524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "277 BUDDY GANEM DR STE A",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783743202",
            "telephone_number": "361-777-3900",
            "fax_number": "361-777-3910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 BUDDY GANEM DR STE A",
            "city": "PORTLAND",
            "state": "TX",
            "postal_code": "783743202",
            "telephone_number": "361-777-3900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1227 Enrique M Barrera Pkwy",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782272210",
            "country_code": "US",
            "telephone_number": "210-538-8386",
            "fax_number": "210-538-8731",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARKER",
        "first_name": "BRENNA",
        "middle_name": "MARIE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-25",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "V0501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; 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.