Provider Demographics
NPI:1568421360
Name:BROOKS, SALLY B (MD)
Entity Type:Individual
Prefix:DR
First Name:SALLY
Middle Name:B
Last Name:BROOKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:7610 STEMMONS FWY
Mailing Address - Street 2:SUITE 500
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4231
Mailing Address - Country:US
Mailing Address - Phone:214-689-5960
Mailing Address - Fax:214-630-7293
Practice Address - Street 1:8220 WALNUT HILL LN
Practice Address - Street 2:SUITE 214 LB 101
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4427
Practice Address - Country:US
Practice Address - Phone:214-368-6707
Practice Address - Fax:214-368-1804
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK0271207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX85Y159OtherBCBSTX
TX045737602Medicaid
TXH06048Medicare UPIN
TX045737602Medicaid
TX100015068Medicare PIN