1932106150 NPI number — DR. CYNTHIA D BROWN M.D.

Table of content: DR. CYNTHIA D BROWN M.D. (NPI 1932106150)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932106150 NPI number — DR. CYNTHIA D BROWN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
CYNTHIA
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932106150
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 W 18TH ST
Provider Second Line Business Mailing Address:
101
Provider Business Mailing Address City Name:
MT PLEASANT
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75455-2309
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-572-9050
Provider Business Mailing Address Fax Number:
903-572-9050

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 W 18TH ST
Provider Second Line Business Practice Location Address:
101
Provider Business Practice Location Address City Name:
MT PLEASANT
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75455-2309
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-572-9050
Provider Business Practice Location Address Fax Number:
903-572-9050
Provider Enumeration Date:
07/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RP1001X , with the licence number:  9700874 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 290013995 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 129C2 . This is a "BCBS NC" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".
  • Identifier: 89129C2 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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