Provider Demographics
NPI:1295769586
Name:ZIMMERMAN, BRETT (MD)
Entity type:Individual
Prefix:DR
First Name:BRETT
Middle Name:
Last Name:ZIMMERMAN
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 1:49 POST OAK RUN
Mailing Address - Street 2:
Mailing Address - City:INEZ
Mailing Address - State:TX
Mailing Address - Zip Code:77968-3719
Mailing Address - Country:US
Mailing Address - Phone:205-240-1159
Mailing Address - Fax:
Practice Address - Street 1:49 POST OAK RUN
Practice Address - Street 2:
Practice Address - City:INEZ
Practice Address - State:TX
Practice Address - Zip Code:77968
Practice Address - Country:US
Practice Address - Phone:205-240-1159
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7517207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALBZ9639317OtherDEA