Provider Demographics
NPI:1073663688
Name:GREGER, BROOKS ROSS II (CRNA)
Entity Type:Individual
Prefix:MR
First Name:BROOKS
Middle Name:ROSS
Last Name:GREGER
Suffix:II
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6313 PRAIRIE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-5067
Mailing Address - Country:US
Mailing Address - Phone:469-383-9991
Mailing Address - Fax:
Practice Address - Street 1:419 W 5TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-5026
Practice Address - Country:US
Practice Address - Phone:432-640-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-12
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX688504367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered