BRAZOSPORT COMMUNITY MEDICAL CLINIC (NPI# 1881649747) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881649747 |
| Entity Type | Organization |
| Organization Name | BRAZOSPORT COMMUNITY MEDICAL CLINIC |
| Practice Address |
606 N Gulf Blvd Freeport TX 77541-3902 |
| Practice Telephone | 9798719453 |
| Practice Fax Number | 9798719429 |
| Mailing Telephone | 9798719453 |
| Mailing Fax Number | 9798719429 |
| Enumeration Date | 2006-05-22 |
| Last Update Date | 2015-05-04 |
| Authorized Official Name | MR. INYANG E WILSON (CEO/PA) |
| Authorized Official Telephone | 9798719453 |
| Authorized Official Credential | PA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | PA00933 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 138038816 | 05 | |
| TX | 162136901 | 05 |
| Street Address |
606 N GULF BLVD |
| City | FREEPORT |
| State | TX |
| Zip Code | 77541-3902 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053359885 | Inyang E Wilson | Physician Assistant | 606 N Gulf Blvd, Freeport, TX 77541-3902 | 2006-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174909022 | Aida Garza | Counselor | 200 W. 2nd St., Suite 228, Freeport, TX 77541 | 2015-08-03 |
| 1982960720 | Adapt Programs, LLC | Clinic/Center | 210 W 1st Street, Suite B Room 1, Freeport, TX 77541 | 2012-04-05 |
| 1467976530 | Carmen Garcia-garza | Nurse Practitioner | 905 N Gulf Blvd, Freeport, TX 77541 | 2017-07-31 |
| 1326380767 | Mohamed Awni Zebda | Pediatrics | 905 N Gulf Blvd, Freeport, TX 77541 | 2013-03-25 |
| 1003022898 | Nusrat Ahmed | Family Medicine | 905 N Gulf Blvd, Freeport, TX 77541 | 2007-05-16 |
| 1952707861 | Melissa Colvin | Nurse Practitioner | 602 Copper Rd, Freeport, TX 77541-3001 | 2014-11-05 |
| 1083926752 | Stanley H Miller | Preventive Medicine | 2301 N Brazosport Blvd # B-101, Dow Chemical Health Services, Freeport, TX 77541-3203 | 2010-07-09 |
| 1063633303 | Beverly E Morrison | Physical Medicine & Rehabilitation | 1102 N Brazosport Blvd, Freeport, TX 77541-3504 | 2007-05-02 |
| 1114917846 | Atlas Dental Lp | Dentist | 1723 N Avenue K, Freeport, TX 77541-3605 | 2005-10-25 |
| 1457727109 | Shine Dental Pllc | Dentist | 1723 N Avenue K, Freeport, TX 77541-3605 | 2015-08-17 |
| Find all providers in zip 77541 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104156769 | Lisa W Lucas | Family Medicine | 42 Mallett Dr Ste 3, Freeport, ME 04032-1355 | 2010-01-05 |
| 1376746982 | Stephen Welch | Family Medicine | 3002 Wheatland Ter, Freeport, IL 61032-2996 | 2007-06-10 |
| 1790837714 | Marc-anthony Louis Charles | Family Medicine | 334 W Merrick Rd, Freeport, NY 11520 | 2007-01-18 |
| 1821194267 | David Martin Johnson | Family Medicine | 36 Old South Freeport Road, Freeport, ME 04032-6146 | 2006-09-15 |
| 1659481844 | Michael J. Muise | Family Medicine | 1301 Kiwanis Dr, Freeport, IL 61032-6907 | 2006-08-30 |
| 1477595858 | Freeport Family Medicine LLC | Family Medicine | 1588 Highway 20 West, Freeport, FL 32439 | 2006-06-12 |
| 1700824000 | Brian Keith Knighton | Family Medicine | 42 Mallett Dr, Freeport, ME 04032-1355 | 2006-06-02 |
| 1972579175 | Michael R Perry | Family Medicine | 10 W Linden St, Freeport, IL 61032-3310 | 2006-02-27 |
| 1780657270 | Brian T Bennett | Family Medicine | 3001 Highland View Dr, Freeport, IL 61032-6942 | 2006-02-07 |
| 1528030202 | Beth A Kalnins | Family Medicine | 1045 W Stephenson St, Freeport, IL 61032-4864 | 2006-02-06 |
| Find all providers in FREEPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.