Larry Wayne Brockman, PA-C is a
Physician Assistant based in Forest Hill, Texas. Larry Wayne Brockman is licensed to practice in Texas (license number 552930) and his current practice location is
3150 Horton Rd, Forest Hill, Texas. He can be reached at his office (for appointments etc.) via phone at
(817) 534-8400.
NPI number for Larry Wayne Brockman is 1760792469 and his current mailing address is 3150 Horton Rd, Forest Hill, Texas. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1760792469.
Provider's Profile
| Full Name | Larry Wayne Brockman |
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| Gender | Male |
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| Speciality | Physician Assistant |
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| Location | 3150 Horton Rd, Forest Hill, Texas |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1760792469
- Provider Enumeration Date: 10/14/2010
- Last Update Date: 11/16/2010
Medical Identifiers
Medical identifiers for Larry Wayne Brockman such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1760792469 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 552930 (Texas) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Larry Wayne Brockman is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Larry Wayne Brockman, PA-C
3150 Horton Rd,
Forest Hill, TX 76119-5905
Ph: (817) 534-8400 | Larry Wayne Brockman, PA-C
3150 Horton Rd,
Forest Hill, TX 76119-5905
Ph: (817) 534-8400 |
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