Provider Demographics
NPI:1285880666
Name:BROWN, TERRENCE HOUSTON (PHARM D)
Entity type:Individual
Prefix:
First Name:TERRENCE
Middle Name:HOUSTON
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 BUSINESS PARK DR
Mailing Address - Street 2:STE D
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-6015
Mailing Address - Country:US
Mailing Address - Phone:601-956-6228
Mailing Address - Fax:
Practice Address - Street 1:100 BUSINESS PARK DR
Practice Address - Street 2:STE D
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-6015
Practice Address - Country:US
Practice Address - Phone:601-956-6228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-17
Last Update Date:2014-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH023879183500000X
MST-0108811835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric
No183500000XPharmacy Service ProvidersPharmacist