1205801826 NPI number — DAWN BROWN M.D.

Table of content: DAWN BROWN M.D. (NPI 1205801826)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205801826 NPI number — DAWN BROWN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
DAWN
Provider Middle Name:
Provider Name Prefix Text:
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:
1205801826
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1500 UNIVERSITY DR E
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
COLLEGE STATION
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77840-2600
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
979-846-1100
Provider Business Mailing Address Fax Number:
979-260-9390

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3370 S TEXAS AVE
Provider Second Line Business Practice Location Address:
#B
Provider Business Practice Location Address City Name:
BRYAN
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77802-3127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
979-595-1700
Provider Business Practice Location Address Fax Number:
979-595-1740
Provider Enumeration Date:
02/17/2006

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: 207V00000X , with the licence number:  K2064 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: E-5850 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1497183883 . This is a "ST. JOSEPH HEALTH POINT BRYAN-NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 154467801 . This is a "FACILITY MEDICAID TPI: BCSCHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1275726853 . This is a "COLLEGE STATION CHC/ABC CLINIC FACILITY NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1649265646 . This is a "FACILITY NPI: BRYAN COLLEGE STATION COMMUNITY HEALTH CENTER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 45-1942 . This is a "FACILITY MC #-BCSCHC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 037204701 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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