Dale W Brock

NPI #1013364710 in Liberty, Texas

Provider Information

NPI Number: 1013364710
Entity Type: Organization
Organization Name: Dale W Brock
Primary Specialty: Nurse Practitioner
Enumeration Date: May 23, 2016
Last Updated: May 23, 2016

Practice Location

Address: 2800 BEAUMONT AVE
Address 2: SUITE A
City: Liberty
State: Texas
ZIP Code: 77575-5126
Phone: (936) 336-3100

Authorized Official

Name: DALE W BROCK, APN
Title: OWNER
Phone: (936) 336-3100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nurse Practitioner	363L00000X	Primary

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