Provider Demographics
NPI:1861556631
Name:BROOKS, JEFFREY A (PA-C)
Entity type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:A
Last Name:BROOKS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400-3 E CENTRAL TEXAS EXPY
Mailing Address - Street 2:SUITE A
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-7372
Mailing Address - Country:US
Mailing Address - Phone:254-690-6300
Mailing Address - Fax:254-690-7816
Practice Address - Street 1:4400-3 E CENTRAL TEXAS EXPY
Practice Address - Street 2:SUITE A
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-7372
Practice Address - Country:US
Practice Address - Phone:254-690-6300
Practice Address - Fax:254-690-7816
Is Sole Proprietor?:No
Enumeration Date:2006-12-19
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical