Provider Demographics
NPI:1063528834
Name:BROWN, PHILIP M (MD)
Entity type:Individual
Prefix:
First Name:PHILIP
Middle Name:M
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9101 LYNDON B JOHNSON FWY
Mailing Address - Street 2:SUITE 710
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-2057
Mailing Address - Country:US
Mailing Address - Phone:214-378-7605
Mailing Address - Fax:214-378-7601
Practice Address - Street 1:8210 WALNUT HILL LN
Practice Address - Street 2:SUITE 905
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4405
Practice Address - Country:US
Practice Address - Phone:214-378-7605
Practice Address - Fax:214-378-7601
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-22
Last Update Date:2008-12-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXL5689207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8BM540OtherBCBS
TX8F8940Medicare PIN
TXH25875Medicare UPIN