Provider Demographics
NPI:1023120011
Name:MORRIS, SCOT RICHARD (MD)
Entity type:Individual
Prefix:
First Name:SCOT
Middle Name:RICHARD
Last Name:MORRIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 CROCKETT DRIVE
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5900
Mailing Address - Country:US
Mailing Address - Phone:325-643-5456
Mailing Address - Fax:325-643-9590
Practice Address - Street 1:PEDIATRICS OF BROWNWOOD
Practice Address - Street 2:2500 CROCKETT DRIVE
Practice Address - City:BROWNWOOD
Practice Address - State:TX
Practice Address - Zip Code:76801-5900
Practice Address - Country:US
Practice Address - Phone:325-643-5456
Practice Address - Fax:325-643-9590
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL0436208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
107604OtherSUPERIOR
272092OtherAMERIGROUP
0094GSOtherBCBS
8B8060OtherBCBS
0070668OtherBLUE LINK
107604OtherSUPERIOR