Provider Demographics
NPI:1053716035
Name:BROOKS, ANTHONY DOUGLAS (DC)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:DOUGLAS
Last Name:BROOKS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 BROOKE ADDISON CT
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316-1507
Mailing Address - Country:US
Mailing Address - Phone:253-677-4981
Mailing Address - Fax:
Practice Address - Street 1:1140 N FM 3083 RD W STE 700
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-4569
Practice Address - Country:US
Practice Address - Phone:936-756-3747
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-03
Last Update Date:2022-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60515175111N00000X
TX15151111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor