Unknown Individual – Family Medicine Physician, NPI 1174851208
Family Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
1301, Memorial Drive, Bryan, Brazos County, Texas, 77802, United States
BRYAN, TX 778025205
Phone: (979) 776-8440
Type: Location
State Highway 36 South, Caldwell, Burleson County, Texas, 77836, United States
CALDWELL, TX 778365377
Phone: (210) 573-2625
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
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No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
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No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 77802)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | KS | |
| - | KS | |
| Qualified Audiologist | KS | |
| Qualified Speech Language Pathologist | KS | |
| - | AR | |
| - | KS | |
| Psychiatry, Geriatric Psychiatry | KS | |
| Nurse Practitioner | KS | |
| Qualified Audiologist | KS | |
| Qualified Speech Language Pathologist | KS |
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