Provider Demographics
NPI:1164504585
Name:MORROW, BRENDA S (MD)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:S
Last Name:MORROW
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7400 MERTON MINTER ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-4404
Mailing Address - Country:US
Mailing Address - Phone:210-617-5300
Mailing Address - Fax:
Practice Address - Street 1:3506 21ST ST
Practice Address - Street 2:SUITE 602
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1212
Practice Address - Country:US
Practice Address - Phone:806-722-3600
Practice Address - Fax:806-722-3604
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2019-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3833207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0026LBOtherBCBS TX
TX119923105OtherFIRSTCARE
TX0026LBOtherBCBS TX
TX610482Medicare PIN