Provider Demographics
NPI:1841381100
Name:DARREN GEORGE DO PA
Entity Type:Organization
Organization Name:DARREN GEORGE DO PA
Other - Org Name:BRAZOS FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GEORGE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:817-573-2601
Mailing Address - Street 1:PO BOX 1689
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-7689
Mailing Address - Country:US
Mailing Address - Phone:817-573-2601
Mailing Address - Fax:817-573-2073
Practice Address - Street 1:303 W PEARL ST
Practice Address - Street 2:
Practice Address - City:GRANBURY
Practice Address - State:TX
Practice Address - Zip Code:76048-2408
Practice Address - Country:US
Practice Address - Phone:817-573-2601
Practice Address - Fax:817-573-2073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5768207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXA001OtherCHAMPUS
TXCH8625OtherRAILROAD MEDICARE
TXA001OtherCHAMPUS
TX00772NMedicare PIN