| C. Brooks Smith M.d. & Associates | |
|
1204 Medical Plaza Ct Granbury TX 76048-5653 | |
| (817) 573-5688 | |
| (817) 573-5760 |
| Full Name | C. Brooks Smith M.d. & Associates |
|---|---|
| Speciality | Family Medicine |
| Location | 1204 Medical Plaza Ct, Granbury, Texas |
| Authorized Official Name and Position | Charles Brooks Smith (OWNER) |
| Authorized Official Contact | 8175735688 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| C. Brooks Smith M.d. & Associates 805 Hill Blvd Unit 104 Unit 104 Granbury TX 76048-1482 Ph: () - | C. Brooks Smith M.d. & Associates 1204 Medical Plaza Ct Granbury TX 76048-5653 Ph: (817) 573-5688 |
| NPI Number | 1558459297 |
|---|---|
| Provider Enumeration Date | 10/10/2006 |
| Last Update Date | 08/27/2021 |
| Medicare PECOS PAC ID | 6406839034 |
|---|---|
| Medicare Enrollment ID | O20040612000348 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558459297 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | J9921 (Texas) | Primary |
| Provider Name | Charles Brooks Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790780930 PECOS PAC ID: 4385627934 Enrollment ID: I20040612000484 |
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Depot Bay,inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 805 Hill Blvd, Suite 106, Granbury, TX 76048 Phone: 817-579-7770 | |
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