Provider Demographics
NPI:1699895078
Name:BROOKS, GEORGE ALFRED (MD PHD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ALFRED
Last Name:BROOKS
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19703 HIGHWAY 59 N STE B
Mailing Address - Street 2:#848
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-3505
Mailing Address - Country:US
Mailing Address - Phone:832-814-2718
Mailing Address - Fax:
Practice Address - Street 1:8901 FM 1960 BYPASS RD W
Practice Address - Street 2:SUITE 204
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77338-4018
Practice Address - Country:US
Practice Address - Phone:281-446-9676
Practice Address - Fax:281-446-8690
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2015-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG4862207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG4862OtherMEDICAL LICENSE
TX834880OtherBCBS PROVIDER NUMBER
TXZ00T82U4Medicaid
TX834880OtherBCBS PROVIDER NUMBER
TX00T82UMedicare ID - Type Unspecified