Basic Information
| Provider Information | |||||||||
| NPI: | 1962687087 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | BREWER & EASTER ENTERPRISES, PLLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | COUNSELORS OF ROUND ROCK | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1970 RAWHIDE DR | ||||||||
| Address2: | SUITE 318 | ||||||||
| City: | ROUND ROCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786816957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123883638 | ||||||||
| FaxNumber: | 5123883634 | ||||||||
| Practice Location | |||||||||
| Address1: | 1970 RAWHIDE DR | ||||||||
| Address2: | SUITE 318 | ||||||||
| City: | ROUND ROCK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 786816957 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5123883638 | ||||||||
| FaxNumber: | 5123883634 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/08/2008 | ||||||||
| LastUpdateDate: | 02/25/2010 | ||||||||
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| AuthorizedOfficialLastName: | BREWER | ||||||||
| AuthorizedOfficialFirstName: | CAROLYN | ||||||||
| AuthorizedOfficialMiddleName: | S | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 5123883638 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YP2500X | TX | Y | 193200000X MULTI-SPECIALTY GROUP | Behavioral Health & Social Service Providers | Counselor | Professional |
No ID Information.