Organization Active NPI

Brazos Vascular Access Center, PLLC

  • Nephrology Physician
  • Bryan, TX
National Provider Identifier
1982955175
Registry record updated Sep 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
Legal business name
BRAZOS VASCULAR ACCESS CENTER, PLLC
Practice address
1673 Briarcrest Dr
Ste 100B
Bryan, TX 77802-2737
Phone
(210) 616-9990
Fax
(210) 298-9416
NPI assigned
Sep 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2012

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

Authorized official

Name
Dr. Emmanuel Anekwe, MD
Title
President/Owner
Phone
(210) 616-9990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nephrology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RN0300X Primary

Addresses

Primary practice location

1673 Briarcrest Dr
Ste 100B
Bryan, TX 77802-2737

Mailing address

PO Box 29364
San Antonio, TX 78229-0364
Phone (210) 616-9990

Other identifiers 2

IdentifierTypeStateIssuer
117880805MedicaidTX
201307003MedicaidTX

National Provider Directory

National Provider Directory

Locations

1673 Briarcrest Dr
Ste 100B
Bryan, TX 77802
Phone (210) 616-9990

NPI Registry JSON

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

{
    "created_epoch": "1348704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1348704000000",
    "number": "1982955175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 29364",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782290364",
            "telephone_number": "210-616-9990",
            "fax_number": "210-298-9416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1673 BRIARCREST DR",
            "address_2": "STE 100B",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778022737",
            "telephone_number": "210-616-9990",
            "fax_number": "210-298-9416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAZOS VASCULAR ACCESS CENTER, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-09-27",
        "last_updated": "2012-09-27",
        "status": "A",
        "authorized_official_last_name": "ANEKWE",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "210-616-9990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "117880805",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201307003",
            "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 Sep 27, 2012; 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.