Provider Demographics
NPI:1124124631
Name:BROWN, ROBERT SCOTT (PSYD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SCOTT
Last Name:BROWN
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4400 BUFFALO GAP RD. STE. 0275
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606
Mailing Address - Country:US
Mailing Address - Phone:325-672-9106
Mailing Address - Fax:325-672-9107
Practice Address - Street 1:4400 BUFFALO GAP RD. STE. 0275
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606
Practice Address - Country:US
Practice Address - Phone:325-672-9106
Practice Address - Fax:325-672-9107
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-15
Last Update Date:2024-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23832103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099316401Medicaid
TX00L54NMedicare ID - Type Unspecified
TXR58458Medicare UPIN