Provider Demographics
NPI:1720347503
Name:BROOKS, THOMAS JEFFERSON IV (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JEFFERSON
Last Name:BROOKS
Suffix:IV
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1 BAYLOR PLZ
Mailing Address - Street 2:BMC 350
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3411
Mailing Address - Country:US
Mailing Address - Phone:713-798-4876
Mailing Address - Fax:713-798-4876
Practice Address - Street 1:1 BAYLOR PLZ
Practice Address - Street 2:BMC 350
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3411
Practice Address - Country:US
Practice Address - Phone:713-798-4876
Practice Address - Fax:713-798-4876
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-14
Last Update Date:2012-05-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXBP100432102084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry