Provider Demographics
NPI:1225911092
Name:BRUMLEY, JILMILLA
Entity type:Individual
Prefix:
First Name:JILMILLA
Middle Name:
Last Name:BRUMLEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 ROLLINGBROOK DR APT 612
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3643
Mailing Address - Country:US
Mailing Address - Phone:281-917-6530
Mailing Address - Fax:
Practice Address - Street 1:3300 ROLLINGBROOK DR APT 612
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3643
Practice Address - Country:US
Practice Address - Phone:281-917-6530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-29
Last Update Date:2025-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172A00000XOther Service ProvidersDriverGroup - Single Specialty