Provider Demographics
NPI:1508999186
Name:BREWER, TERESA L (RN)
Entity Type:Individual
Prefix:MRS
First Name:TERESA
Middle Name:L
Last Name:BREWER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8010 BARNHILL DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-1808
Mailing Address - Country:US
Mailing Address - Phone:832-293-3970
Mailing Address - Fax:281-540-8570
Practice Address - Street 1:8010 BARNHILL DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-1808
Practice Address - Country:US
Practice Address - Phone:832-293-3970
Practice Address - Fax:281-540-8570
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX530370171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0834290001Medicare NSC