Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Brazosport Urology, PA

Organization Urology Physician · NPI 1417177270

Brazosport Urology, PA is an Urology Physician in Lake Jackson, Texas. Licensed in Texas. Registered with an NPI since 2007.

Licensed in
TX
In the registry since
2007
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

115 Abner Jackson Pkwy Ste C
Lake Jackson, TX 77566-5157
Phone: (979) 297-4140
Fax: (979) 297-4919
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence M5052 (TX)

Record details

NPI number1417177270
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Derrick Berger — Practice Manager · (979) 297-4140
NPI enumeratedApril 26, 2007
Last updated in NPPESJune 23, 2008
Mailing address115 Abner Jackson Pkwy, Suite C, Lake Jackson, TX 77566-5157

Other providers in Lake Jackson