Provider Demographics
NPI:1033382668
Name:BRAZOS SA SERVICES
Entity type:Organization
Organization Name:BRAZOS SA SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:CFO
Authorized Official - Phone:832-804-8704
Mailing Address - Street 1:PO BOX 1172
Mailing Address - Street 2:
Mailing Address - City:ALIEF
Mailing Address - State:TX
Mailing Address - Zip Code:77411-1172
Mailing Address - Country:US
Mailing Address - Phone:713-988-8400
Mailing Address - Fax:
Practice Address - Street 1:7324 SOUTHWEST FWY STE 1550
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-2053
Practice Address - Country:US
Practice Address - Phone:713-779-9800
Practice Address - Fax:713-779-9862
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:AMERICAN SURGICAL HOLDINGS INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-04-03
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty