Provider Demographics
NPI:1467997676
Name:BRENHAM WOMENS HEALTH, PLLC
Entity Type:Organization
Organization Name:BRENHAM WOMENS HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:WAYNE
Authorized Official - Last Name:CAMPBELL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-353-5556
Mailing Address - Street 1:605 MEDICAL CT
Mailing Address - Street 2:SUITE 203
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-5404
Mailing Address - Country:US
Mailing Address - Phone:979-353-5556
Mailing Address - Fax:
Practice Address - Street 1:605 MEDICAL CT
Practice Address - Street 2:SUITE 203
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5404
Practice Address - Country:US
Practice Address - Phone:979-353-5556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-23
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3953207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX299990601Medicaid
TX558420Medicare PIN
TX299990601Medicaid