Provider Demographics
NPI:1780978171
Name:BRINK, RUSSELL L (DO)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:L
Last Name:BRINK
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:7777 SOUTHWEST FWY
Mailing Address - Street 2:304
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77074-1802
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7777 SOUTHWEST FWY
Practice Address - Street 2:304
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-1802
Practice Address - Country:US
Practice Address - Phone:713-270-4545
Practice Address - Fax:713-270-9197
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-03
Last Update Date:2019-03-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXP0702207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXD0182867OtherDPS