Provider Demographics
NPI:1972806289
Name:BROOKS, BILLY
Entity Type:Individual
Prefix:MR
First Name:BILLY
Middle Name:
Last Name:BROOKS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3149 CRIMSON CLOVER DR
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:TX
Mailing Address - Zip Code:75134-1655
Mailing Address - Country:US
Mailing Address - Phone:214-235-2081
Mailing Address - Fax:214-525-5490
Practice Address - Street 1:3149 CRIMSON CLOVER DR
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:TX
Practice Address - Zip Code:75134-1655
Practice Address - Country:US
Practice Address - Phone:214-235-2081
Practice Address - Fax:214-525-5490
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health