Provider Demographics
NPI:1467456111
Name:BROOKS, JAMI H (AU)
Entity Type:Individual
Prefix:
First Name:JAMI
Middle Name:H
Last Name:BROOKS
Suffix:
Gender:F
Credentials:AU
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 LAMAR AVE
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-5020
Mailing Address - Country:US
Mailing Address - Phone:903-737-8800
Mailing Address - Fax:903-784-8429
Practice Address - Street 1:3130 LAMAR AVE
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-5020
Practice Address - Country:US
Practice Address - Phone:903-737-8800
Practice Address - Fax:903-784-8429
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-10
Last Update Date:2010-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50734231H00000X
TX14561235Z00000X
TX90573237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089238203Medicaid
TX531542OtherBCBS PROVIDER # AIDS
TX089238206Medicaid
TX528421OtherBCBS PROVIDER # SPEECH
TX089238202Medicaid
TX528465OtherBCBS PROVIDER # AUDIOLOGY
TX089238201Medicaid
TX089238207Medicaid
TX089238207Medicaid