Provider Demographics
NPI:1528148129
Name:BROWN, LYDIA DIANE (APRN)
Entity type:Individual
Prefix:MS
First Name:LYDIA
Middle Name:DIANE
Last Name:BROWN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 S CYNTHIA ST
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1294
Mailing Address - Country:US
Mailing Address - Phone:956-687-7896
Mailing Address - Fax:956-994-9694
Practice Address - Street 1:2101 S CYNTHIA ST
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1294
Practice Address - Country:US
Practice Address - Phone:956-687-7896
Practice Address - Fax:956-994-9694
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN11532363LA2200X
TX790762363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX70177000OtherDPS
TX70177000OtherDPS
MB1271648OtherDEA