Provider Demographics
NPI:1215937255
Name:BRENNAN, THOMAS STEPHEN (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:STEPHEN
Last Name:BRENNAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:242 BLALOCK RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-7307
Mailing Address - Country:US
Mailing Address - Phone:713-975-7542
Mailing Address - Fax:713-789-3847
Practice Address - Street 1:1415 LA CONCHA LN
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-1801
Practice Address - Country:US
Practice Address - Phone:713-790-9080
Practice Address - Fax:713-790-1664
Is Sole Proprietor?:No
Enumeration Date:2005-07-29
Last Update Date:2007-10-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH1743207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8637K3OtherBLUE CROSS BLUE SHIELD
TXPO8637K37Medicaid
TXE38992Medicare UPIN
TXPO8637K37Medicaid