Provider Demographics
NPI:1780380089
Name:BRAZOS FAMILY PRACTICE, PLLC
Entity type:Organization
Organization Name:BRAZOS FAMILY PRACTICE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:MAGNESS
Authorized Official - Suffix:
Authorized Official - Credentials:MD, JD
Authorized Official - Phone:832-443-9668
Mailing Address - Street 1:235 W PALM ST STE 102
Mailing Address - Street 2:
Mailing Address - City:BELLVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77418-1300
Mailing Address - Country:US
Mailing Address - Phone:979-865-8484
Mailing Address - Fax:
Practice Address - Street 1:235 W PALM ST STE 102
Practice Address - Street 2:
Practice Address - City:BELLVILLE
Practice Address - State:TX
Practice Address - Zip Code:77418-1300
Practice Address - Country:US
Practice Address - Phone:979-865-8484
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty