Provider Demographics
NPI:1205098753
Name:PENNINGTON, BRENT LEE (MD)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:LEE
Last Name:PENNINGTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 6696
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-6696
Mailing Address - Country:US
Mailing Address - Phone:361-985-1221
Mailing Address - Fax:361-985-1295
Practice Address - Street 1:600 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78404-2235
Practice Address - Country:US
Practice Address - Phone:361-985-1221
Practice Address - Fax:361-985-1295
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2023-12-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP7534207Q00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP7534OtherTEXAS MEDICAL BOARD