Provider Demographics
NPI:1407868508
Name:BROWN, LEZA MARIE (LAT)
Entity type:Individual
Prefix:
First Name:LEZA
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:LAT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10225 WORTHAM BLVD APT 14204
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3042
Mailing Address - Country:US
Mailing Address - Phone:281-807-1591
Mailing Address - Fax:
Practice Address - Street 1:9811 HUFFMEISTER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77095-2307
Practice Address - Country:US
Practice Address - Phone:281-856-1054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAT27032255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer