Provider Demographics
NPI:1760816920
Name:GARY W BREWTON MD
Entity Type:Organization
Organization Name:GARY W BREWTON MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:GARY
Authorized Official - Middle Name:W
Authorized Official - Last Name:BREWTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-529-9224
Mailing Address - Street 1:1213 HERMANN DR STE 845
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7027
Mailing Address - Country:US
Mailing Address - Phone:713-529-9224
Mailing Address - Fax:713-529-9311
Practice Address - Street 1:1213 HERMANN DR STE 845
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7027
Practice Address - Country:US
Practice Address - Phone:713-529-9224
Practice Address - Fax:713-529-9311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-23
Last Update Date:2013-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty