Provider Demographics
NPI:1265955934
Name:BROOKS, TONYA
Entity type:Individual
Prefix:MRS
First Name:TONYA
Middle Name:
Last Name:BROOKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TONYA
Other - Middle Name:
Other - Last Name:PICKNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPNP-PC
Mailing Address - Street 1:201 AMANDA LN STE 200
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-1392
Mailing Address - Country:US
Mailing Address - Phone:972-937-1300
Mailing Address - Fax:972-937-1389
Practice Address - Street 1:201 AMANDA LN STE 200
Practice Address - Street 2:
Practice Address - City:WAXAHACHIE
Practice Address - State:TX
Practice Address - Zip Code:75165-1392
Practice Address - Country:US
Practice Address - Phone:972-937-1300
Practice Address - Fax:972-937-1389
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2018-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128873363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics