Street, Brock C

Street, Brock C is an individual health care provider with primary practice located at 1500 Cooper St , Fort Worth TX 76104-2710. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Street, Brock C can be contacted via phone (682) 885-7080.

Contact Information

Primary practice address
1500 Cooper St Fort Worth TX 76104-2710
Phone: (682) 885-7080
Fax: (682) 885-7085
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X PA11072 Texas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA11072 Texas

Profile Details

NPI number 1043759731
LBN Legal business name Street, Brock C
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2017
Last updated Apr 6th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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