Individual provider · NPI-1

Stewart T Brooks, PA

Physician Assistant, Surgical · Bryan, TX

NPI number1639174170
StatusActive
Last updated in NPPESAug 12, 2015

Details

NPI
1639174170
Entity type
Individual (NPI-1)
Name
Stewart T Brooks
Credential
PA
Sex
Male
Sole proprietor
No
Enumeration date
Jun 20, 2005
Last updated
Aug 12, 2015

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363AS0400X Physician Assistant, SurgicalPA06723TXYes
363AS0400X Physician Assistant, SurgicalPA10004055WA

Practice location

8441 State Highway 47 Ste 4300
Bryan, TX 77807-3235

Phone 979-776-8896

Mailing address

8441 State Highway 47 Ste 4300
Bryan, TX 77807-3235

Phone 979-776-8896

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