Provider Demographics
NPI:1962422386
Name:BROWN, DAVID SCOTT (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:SCOTT
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:606 TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:COLLEYVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76034-7593
Mailing Address - Country:US
Mailing Address - Phone:817-680-6236
Mailing Address - Fax:817-812-2868
Practice Address - Street 1:431 E STATE HIGHWAY 114 STE 120
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-4416
Practice Address - Country:US
Practice Address - Phone:800-682-4220
Practice Address - Fax:817-812-2868
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD219517207X00000X
TXK1168207XP3100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XP3100XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryPediatric Orthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152988503Medicaid
TX152988507Medicaid
TXP00734509OtherRR MEDICARE PTAN
TX8F21898Medicare PIN
TX152988503Medicaid