Provider Demographics
NPI:1154558534
Name:GRIFFITH, BROOKE (CRNA)
Entity type:Individual
Prefix:MS
First Name:BROOKE
Middle Name:
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:BROOKE
Other - Middle Name:
Other - Last Name:BUTLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:2411 FOUNTAIN VIEW DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77057-4817
Mailing Address - Country:US
Mailing Address - Phone:713-620-4000
Mailing Address - Fax:
Practice Address - Street 1:6720 BERTNER AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2604
Practice Address - Country:US
Practice Address - Phone:832-355-2666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-12
Last Update Date:2022-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693446367500000X
TXAP117935367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX208723102Medicaid
TX208723101Medicaid
TXP00834479OtherRAILROAD MEDICARE
TX8354UUOtherBLUE CROSS BLUE SHIELD
TX208723101Medicaid