Provider Demographics
NPI:1619104346
Name:BRAZORIA COUNTY OBSTETRICS AND GYNECOLOGY, PLLC
Entity Type:Organization
Organization Name:BRAZORIA COUNTY OBSTETRICS AND GYNECOLOGY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GREGORY
Authorized Official - Middle Name:C
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-849-5940
Mailing Address - Street 1:146 E HOSPITAL DR
Mailing Address - Street 2:208
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-4169
Mailing Address - Country:US
Mailing Address - Phone:979-849-5940
Mailing Address - Fax:979-849-5944
Practice Address - Street 1:146 E HOSPITAL DR
Practice Address - Street 2:208
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-4169
Practice Address - Country:US
Practice Address - Phone:979-849-5940
Practice Address - Fax:979-849-5944
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-21
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty