Provider Demographics
NPI:1306151634
Name:BROWN, JONATHAN EDWARD (PA-C)
Entity type:Individual
Prefix:MR
First Name:JONATHAN
Middle Name:EDWARD
Last Name:BROWN
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8000 RESEARCH FOREST DR STE 360
Mailing Address - Street 2:
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77382-1559
Mailing Address - Country:US
Mailing Address - Phone:281-362-7012
Mailing Address - Fax:281-362-9170
Practice Address - Street 1:8000 RESEARCH FOREST DR STE 360
Practice Address - Street 2:
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77382-1559
Practice Address - Country:US
Practice Address - Phone:281-362-7012
Practice Address - Fax:281-362-9170
Is Sole Proprietor?:No
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA03658363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX760230463OtherTIN