| NPI | 1528693082 |
|---|---|
| Doing Business As | CHN AT BRAZOSPORT |
| Entity Type | Organization |
| Authorized Contact | BRANDY SMITH Credentialing Coordinator 281-824-1480 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2022-12-05 |