NPIMap

Organization Active NPI

Brenham Clinic Assn

  • Pediatrics Physician
  • Brenham, TX
National Provider Identifier
1528172012
Registry record updated Oct 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
K6753 Issued in TX
Legal business name
BRENHAM CLINIC ASSN
Practice address
600 North Park St
Brenham, TX 77833-2610
Phone
(979) 836-6153
NPI assigned
Aug 19, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2007

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

Authorized official

Name
Gracie Slattery, RN
Title
Administrator
Phone
(979) 836-6153

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X F4241 TX
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X K6753 TX Primary

Addresses

Primary practice location

600 North Park St
Brenham, TX 77833-2610

Mailing address

600 North Park St
Brenham, TX 77833-2610
Phone (979) 836-6153

National Provider Directory

National Provider Directory
Tax ID family
Brenham Clinic Assn8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1155945600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193443200000",
    "number": "1528172012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 NORTH PARK ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778332610",
            "telephone_number": "979-836-6153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 NORTH PARK ST",
            "city": "BRENHAM",
            "state": "TX",
            "postal_code": "778332610",
            "telephone_number": "979-836-6153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENHAM CLINIC ASSN",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-19",
        "last_updated": "2007-10-27",
        "status": "A",
        "authorized_official_last_name": "SLATTERY",
        "authorized_official_first_name": "GRACIE",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "979-836-6153",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "TX",
            "license": "F4241",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "TX",
            "license": "K6753",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brenham, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2007; 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.