Provider Demographics
NPI:1780835272
Name:OB GYN OF BROWNSVILLE PLLC
Entity Type:Organization
Organization Name:OB GYN OF BROWNSVILLE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-852-1550
Mailing Address - Street 1:100 E ALTON GLOOR BLVD STE B
Mailing Address - Street 2:SUITE 130
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3354
Mailing Address - Country:US
Mailing Address - Phone:956-350-4821
Mailing Address - Fax:
Practice Address - Street 1:100 E ALTON GLOOR BLVD STE B
Practice Address - Street 2:SUITE 130
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3354
Practice Address - Country:US
Practice Address - Phone:956-350-4821
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-02
Last Update Date:2010-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00Z954Medicare PIN