Provider Demographics
NPI:1396799151
Name:BROWN, BRIAN JAMES (RN NP)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:JAMES
Last Name:BROWN
Suffix:
Gender:M
Credentials:RN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-234-2987
Practice Address - Street 1:3500 GASTON AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246
Practice Address - Country:US
Practice Address - Phone:214-826-8822
Practice Address - Fax:214-826-9792
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2015-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX641170363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159897102Medicaid
TX159897106Medicaid
TX8A9204Medicare PIN
TX159897106Medicaid
TX8A9283Medicare PIN
TXP00054440Medicare PIN
TXP00054441Medicare PIN