MEDICARE: MR. ROBERT MATTHEW BROWNE CCP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	242T00000X	Perfusionist	PF0475	TX

General Provider Information

NPI Number	:	1265554414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT MATTHEW BROWNE CCP

Provider Business Mailing Address
First Line	:	14603 HUEBNER RD BLDG 28
Second Line	:	STE. 28101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5497
Country	:	US
Telephone Number	:	210-614-7074
Fax Number	:	210-614-7091

Provider Business Practice Location Address
First Line	:	14603 HUEBNER RD BLDG 28
Second Line	:	STE. 28101
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-5497
Country	:	US
Telephone Number	:	210-614-7074
Fax Number	:	210-614-7091

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/06/2007
Last Update Date	:	11/16/2015

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