Provider Demographics
NPI:1801833744
Name:BROBBEY, GWENDOLYN ELIZABETH (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:GWENDOLYN
Middle Name:ELIZABETH
Last Name:BROBBEY
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 SHADOW CREEK PKWY
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7298
Mailing Address - Country:US
Mailing Address - Phone:713-442-0000
Mailing Address - Fax:
Practice Address - Street 1:1915 LAKEFRONT DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1651
Practice Address - Country:US
Practice Address - Phone:281-969-8860
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG0899208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX121542805Medicaid
412069533 0001OtherCIGNA PRV ID NUMBER
TX121542809Medicaid
42069533001OtherTRICARE PROV ID NUMBER
TXS0045716OtherSTATE DPS NUMBER
TX00000034JVOtherBCBS PROV. NUMBER
VA10018140OtherAMERIGROUP PROV ID NUMBER
3056377OtherAETNA PROV NUMBER
1801833744OtherNPI
236-282-0OtherECFMG NUMBER
MA48268OtherMASS BD OF REGISTRATION
0007929017OtherAETNA PIN
TX121542810Medicaid
31381OtherAMERICAN BD OF PEDIATRICS
45D1007578OtherCLIA CERT. OF WAIVER
TXG0899OtherST. BD OF MED EXAMINERS
TX121542806Medicaid
TX121542811Medicaid
236-282-0OtherECFMG
236-282-0OtherECFMG
42069533001OtherTRICARE PROV ID NUMBER
412069533 0001OtherCIGNA PRV ID NUMBER