1285793224 NPI number — ELLIE SOPHIA BROWN M.S., L.P.C.

Table of content: ELLIE SOPHIA BROWN M.S., L.P.C. (NPI 1285793224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285793224 NPI number — ELLIE SOPHIA BROWN M.S., L.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
ELLIE
Provider Middle Name:
SOPHIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.S., L.P.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BROWN
Provider Other First Name:
ELI
Provider Other Middle Name:
BERTA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S., L.P.C., N.C.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1285793224
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11303 HUGHES ROAD, OFFICE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77089
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-317-0021
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
531 FM 359 RD S
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKSHIRE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77423-9006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
281-822-4219
Provider Business Practice Location Address Fax Number:
281-375-5134
Provider Enumeration Date:
12/06/2006

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: 101YP2500X , with the licence number:  20249 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com