Provider Demographics
NPI:1215047733
Name:DUPERVAL-BROWNLEE, TAMARAH (MD, MPH)
Entity type:Individual
Prefix:
First Name:TAMARAH
Middle Name:
Last Name:DUPERVAL-BROWNLEE
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 E UNIVERSITY AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-6814
Mailing Address - Country:US
Mailing Address - Phone:512-868-1124
Mailing Address - Fax:512-868-9894
Practice Address - Street 1:205 E UNIVERSITY AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-6814
Practice Address - Country:US
Practice Address - Phone:847-858-6109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-099603207Q00000X
TXN8908207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH46215Medicare UPIN