DR. PHILIP R. BRACKETT (NPI# 1396792453) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1396792453 |
Entity Type | Individual |
Full Name | DR. PHILIP R. BRACKETT |
Credential | D.O. |
Practice Address |
1333 S Sam Houston Blvd Houston MO 65483-2046 |
Practice Telephone | 4179673311 |
Practice Fax Number | 4179673764 |
Mailing Telephone | 4179673311 |
Mailing Fax Number | 4179673764 |
Enumeration Date | 2006-05-27 |
Last Update Date | 2009-07-17 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 207Q00000X | Family Medicine | 29720 | MO | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MO | 240293274 | 05 | |
MO | RH MEDICAID (CLINIC) | 1447412770 | 01 |
MO | RH MEDICARE | 26-8630 | 01 |
Street Address |
1333 S SAM HOUSTON BLVD |
City | HOUSTON |
State | MO |
Zip Code | 65483-2046 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1578548517 | Qasim Mustafa Bajwa | Radiology | 1333 S Sam Houston Blvd, Dept of Radiology, Houston, MO 65483-2046 | 2005-12-13 |
1487994208 | Tracey A Arwood | Advanced Practice Midwife | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2013-02-15 |
1679885644 | Selina A Jeanise | Emergency Medicine | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2010-07-07 |
1326246000 | Texas County Memorial Hospital | Clinic/Center | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2007-07-05 |
1679637185 | Brett L Welden | Nurse Practitioner | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-12-20 |
1356402226 | Texas County Memorial Hospital | General Acute Care Hospital | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-12-13 |
1881755759 | Texas County Memorial Hospital | General Acute Care Hospital | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-12-13 |
1255492658 | Larry Wayne Ladd | Nurse Anesthetist, Certified Registered | 1333 S Sam Houston Blvd, Texas Co Memorial Hospital, Houston, MO 65483 | 2006-12-12 |
1023179298 | Texas County Memorial Hospital | Medicare Defined Swing Bed Unit | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-12-12 |
1942244165 | Oren K Broughton | Emergency Medicine | 1333 S Sam Houston Blvd, Houston, MO 65483-2046 | 2006-06-16 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164921300 | Texas County Memorial Hospital | Clinic/Center | 1333 S Sam Houston Blvd Ste A, Houston, MO 65483 | 2018-02-02 |
1942657606 | Community Counseling Services of Missouri, L.L.C. | Counselor | 1591 C North Highway 63, Houston, MO 65483 | 2016-05-23 |
1083081681 | Vicky Birdsong | Registered Nurse | 1597 North Hwy 63, Houston, MO 65483 | 2015-08-31 |
1578794525 | Mary Jane Lybyer | Speech-Language Pathologist | 423 W. Pine, Houston, MO 65483 | 2009-08-06 |
1851530257 | Womack Chiropractic Center, PC | Chiropractor | 118 W. Main St., Houston, MO 65483 | 2009-02-10 |
1588793459 | Houston R-1 School District | Local Education Agency (LEA) | 204 W. Spruce, Houston, MO 65483 | 2007-03-05 |
1487783296 | Mercy Clinic-springfield Communities | Family Medicine | 1422 S Sam Houston Blvd, Houston, MO 65483 | 2007-03-05 |
1164587770 | Texas County Memorial Hospital | Pharmacy | 1422 S Sam Houston Blvd Ste 100, Houston, MO 65483 | 2006-12-26 |
1336226513 | Deborah Belt-kell | Counselor | Tcmh Annex - Mental Health, 1333 S Sam Houston Blvd, Houston, MO 65483 | 2006-11-01 |
1164483921 | Christopher O Baldwin | Obstetrics & Gynecology | 1337 S Sam Houston Blvd, Houston, MO 65483 | 2006-03-31 |
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Taxonomy Code | 207Q00000X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Family Medicine |
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
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1972121416 | Community Medical Clinic LLC | Family Medicine | 10008 Bellaire Blvd, Suite 108, Houston, TX 77072 | 2020-07-10 |
1164048526 | Clinica San Lucas Fuqua | Family Medicine | 11019 Fuqua St, Houston, TX 77089-2510 | 2020-06-22 |
1699397240 | Urgent Health Solutions Woodlake | Family Medicine | 9668 Westheimer Rd Ste 600, Houston, TX 77063-3252 | 2020-05-16 |
1649899964 | Lermnaim LLC | Family Medicine | 2919 Fm 1960 Rd Ste 120, Houston, TX 77073-2621 | 2020-04-16 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.