Organization Active NPI

SCB Clinic, PLLC

  • Clinic/Center
  • Lake Jackson, TX
National Provider Identifier
1558465286
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
574974 Issued in TX
Legal business name
SCB CLINIC, PLLC
Practice address
120 Flag Lake Dr Ste 2
Lake Jackson, TX 77566
Phone
(979) 297-8800
Fax
(979) 297-0300
NPI assigned
Sep 12, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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

Authorized official

Name
Mrs. Stephani Curtis Bradley, RN FNP-C
Title
Provider
Phone
(979) 297-8800

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 574974 TX Primary

Addresses

Primary practice location

120 Flag Lake Dr Ste 2
Lake Jackson, TX 77566

Mailing address

120 Flag Lake Dr Ste 2
Lake Jackson, TX 77566-6292
Phone (979) 297-8800

National Provider Directory

National Provider Directory

Locations

207A That Way St
Lake Jackson, TX 77566
Phone 97927978800

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": "1158019200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1668988800000",
    "number": "1558465286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 FLAG LAKE DR STE 2",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "775666292",
            "telephone_number": "979-297-8800",
            "fax_number": "979-297-0300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 FLAG LAKE DR STE 2",
            "city": "LAKE JACKSON",
            "state": "TX",
            "postal_code": "77566",
            "telephone_number": "979-297-8800",
            "fax_number": "979-297-0300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SCB CLINIC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-12",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A",
        "authorized_official_last_name": "BRADLEY",
        "authorized_official_first_name": "STEPHANI",
        "authorized_official_middle_name": "CURTIS",
        "authorized_official_title_or_position": "PROVIDER",
        "authorized_official_telephone_number": "979-297-8800",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN FNP-C"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "TX",
            "license": "574974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Jackson, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2022; 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.