Provider Demographics
NPI:1083324040
Name:BROSOWSKE, GEORGE (DNP)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:
Last Name:BROSOWSKE
Suffix:
Gender:M
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6927 COUNTRY ROSE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78240-4464
Mailing Address - Country:US
Mailing Address - Phone:806-228-5224
Mailing Address - Fax:
Practice Address - Street 1:6927 COUNTRY ROSE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-4464
Practice Address - Country:US
Practice Address - Phone:806-228-5224
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-30
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1099670363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health