Provider Demographics
NPI:1700968005
Name:HARPER, BROCK E (MD)
Entity Type:Individual
Prefix:
First Name:BROCK
Middle Name:E
Last Name:HARPER
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 1:4701 BEE CAVES RD STE 201
Mailing Address - Street 2:
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-5366
Mailing Address - Country:US
Mailing Address - Phone:512-518-4992
Mailing Address - Fax:866-298-0735
Practice Address - Street 1:2005 N LAKELINE BLVD UNIT B
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-2473
Practice Address - Country:US
Practice Address - Phone:512-518-4690
Practice Address - Fax:866-298-0735
Is Sole Proprietor?:No
Enumeration Date:2006-10-19
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN5709207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX213911502Medicaid
TX282305YRG5Medicare PIN