Provider Demographics
NPI:1124720107
Name:BROWN, AUDREY LEIGH (PA-C)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:LEIGH
Last Name:BROWN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12255 UNIVERSITY DR STE 150
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-9489
Mailing Address - Country:US
Mailing Address - Phone:972-542-4646
Mailing Address - Fax:972-542-0909
Practice Address - Street 1:12255 UNIVERSITY DR STE 150
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-9489
Practice Address - Country:US
Practice Address - Phone:972-542-4646
Practice Address - Fax:972-542-0909
Is Sole Proprietor?:No
Enumeration Date:2023-03-21
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPA-1169363A00000X
TXPA17997363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant