Provider Demographics
NPI:1154136935
Name:BROWN, SHELTON LEWIS
Entity type:Individual
Prefix:
First Name:SHELTON
Middle Name:LEWIS
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2701 LITTLE ELM PKWY STE 100-574
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-6672
Mailing Address - Country:US
Mailing Address - Phone:094-092-3087
Mailing Address - Fax:203-654-3613
Practice Address - Street 1:2701 LITTLE ELM PKWY STE 100-574
Practice Address - Street 2:
Practice Address - City:LITTLE ELM
Practice Address - State:TX
Practice Address - Zip Code:75068-6672
Practice Address - Country:US
Practice Address - Phone:094-092-3087
Practice Address - Fax:203-654-3613
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX08678992343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)