| Brazosport Community Medical Clinic | |
|
606 N Gulf Blvd Freeport TX 77541-3902 | |
| (979) 871-9453 | |
| (979) 871-9429 |
| Full Name | Brazosport Community Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 606 N Gulf Blvd, Freeport, Texas |
| Authorized Official Name and Position | Inyang E Wilson (CEO/PA) |
| Authorized Official Contact | 9798719453 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Brazosport Community Medical Clinic 606 N Gulf Blvd Freeport TX 77541-3902 Ph: (979) 871-9453 | Brazosport Community Medical Clinic 606 N Gulf Blvd Freeport TX 77541-3902 Ph: (979) 871-9453 |
| NPI Number | 1881649747 |
|---|---|
| Provider Enumeration Date | 05/22/2006 |
| Last Update Date | 05/04/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881649747 | NPI | - | NPPES |
| 138038816 | Medicaid | TX | |
| 162136901 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | PA00933 (Texas) | Primary |
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