Provider Demographics
NPI:1306887534
Name:BROWN, WILLIAM CLAY (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CLAY
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 LONE STAR DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-6516
Mailing Address - Country:US
Mailing Address - Phone:713-851-3008
Mailing Address - Fax:
Practice Address - Street 1:1178 2ND ST
Practice Address - Street 2:
Practice Address - City:WINNIE
Practice Address - State:TX
Practice Address - Zip Code:77665-9310
Practice Address - Country:US
Practice Address - Phone:409-296-9505
Practice Address - Fax:409-296-2506
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2007-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3859207QA0401X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0038MQOtherBCBS GROUP NUMBER
TX179381201Medicaid
TX8S2463OtherBCBS INDIVIDUAL NUMBER
TX8S2463OtherBCBS INDIVIDUAL NUMBER
TX8S2463OtherBCBS INDIVIDUAL NUMBER