Provider Demographics
NPI:1144352881
Name:BRAZOS COUNTY
Entity type:Organization
Organization Name:BRAZOS COUNTY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SANTOS
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVARRETTE
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:979-361-4440
Mailing Address - Street 1:201 N TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77803-5317
Mailing Address - Country:US
Mailing Address - Phone:979-361-4440
Mailing Address - Fax:979-823-2275
Practice Address - Street 1:201 N TEXAS AVE
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77803-5317
Practice Address - Country:US
Practice Address - Phone:979-361-4440
Practice Address - Fax:979-823-2275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 261QA0005X, 261QC1500X, 363L00000X
TX261QP0905X261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or LocalGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QA0005XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Family Planning Facility
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity HealthGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX209166235OtherBLUE CROSS BLUE SHIELD
TX1309825-04Medicaid
TX1144352881Medicaid