Provider Demographics
NPI:1215472550
Name:BRAZORIA COUNTY ASSOCIATION FOR CITIZENS WITH HANDICAPS - BUSTER'S KID
Entity type:Organization
Organization Name:BRAZORIA COUNTY ASSOCIATION FOR CITIZENS WITH HANDICAPS - BUSTER'S KID
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR, BUSTER'S KIDS
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPMAN
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:979-799-6231
Mailing Address - Street 1:120 E HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:ANGLETON
Mailing Address - State:TX
Mailing Address - Zip Code:77515-4112
Mailing Address - Country:US
Mailing Address - Phone:979-849-2447
Mailing Address - Fax:
Practice Address - Street 1:120 E HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:ANGLETON
Practice Address - State:TX
Practice Address - Zip Code:77515-4112
Practice Address - Country:US
Practice Address - Phone:979-849-2447
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:BRAZORIA COUNTY ASSOCIATION FOR CITIZENS WITH HANDICAPS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-12-22
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty