Provider Demographics
NPI:1922310556
Name:BRAZORIA COUNTY CT INC
Entity Type:Organization
Organization Name:BRAZORIA COUNTY CT INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:NEIDERT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-792-6736
Mailing Address - Street 1:2760 BRAZOS PKWY
Mailing Address - Street 2:C
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-7048
Mailing Address - Country:US
Mailing Address - Phone:979-849-5700
Mailing Address - Fax:979-849-5785
Practice Address - Street 1:2760 BRAZOS PKWY
Practice Address - Street 2:C
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-7048
Practice Address - Country:US
Practice Address - Phone:979-849-5700
Practice Address - Fax:979-849-5785
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-12
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology