1497039234 NPI number — MISS LEANORA LOUISE BROWN C.N.S.

Table of content: MISS LEANORA LOUISE BROWN C.N.S. (NPI 1497039234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497039234 NPI number — MISS LEANORA LOUISE BROWN C.N.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROWN
Provider First Name:
LEANORA
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
C.N.S.
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:
1497039234
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
970 HESTERS CROSSING RD
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
ROUND ROCK
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
78681-8027
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
512-238-0762
Provider Business Mailing Address Fax Number:
512-341-7370

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
970 HESTERS CROSSING RD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
ROUND ROCK
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
78681-8027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
512-238-0762
Provider Business Practice Location Address Fax Number:
512-341-7370
Provider Enumeration Date:
09/28/2011

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: 364SA2200X , with the licence number:  PENDING , 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)





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