Provider Demographics
NPI:1528165594
Name:BROOKSHIRE, RALPH HAMILTON III (DO)
Entity type:Individual
Prefix:
First Name:RALPH
Middle Name:HAMILTON
Last Name:BROOKSHIRE
Suffix:III
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4199
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-4199
Mailing Address - Country:US
Mailing Address - Phone:956-322-7662
Mailing Address - Fax:956-338-5709
Practice Address - Street 1:2511 CORNERSTONE BLVD STE 2511
Practice Address - Street 2:
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539-8463
Practice Address - Country:US
Practice Address - Phone:956-322-7662
Practice Address - Fax:956-338-5709
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL9113208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX172284507Medicaid
TXB127865Medicare PIN
TX172284507Medicaid
TXB127864Medicare PIN