MEDICARE: DR. WILLIAM CLAY BROWN MD

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	207QA0401X	Addiction Medicine (Family Medicine) Physician	H3859	TX
2	207Q00000X	Family Medicine Physician	H3859	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0038MQ	OTHER	TX	BCBS GROUP NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	8S2463	OTHER	TX	BCBS INDIVIDUAL NUMBER

General Provider Information

NPI Number	:	1306887534
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM CLAY BROWN MD

Provider Business Mailing Address
First Line	:	1105 LONE STAR DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-6516
Country	:	US
Telephone Number	:	713-851-3008
Fax Number	:

Provider Business Practice Location Address
First Line	:	1178 2ND ST
Second Line	:
City	:	WINNIE
State	:	TX
Zip	:	77665-9310
Country	:	US
Telephone Number	:	409-296-9505
Fax Number	:	409-296-2506

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

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	08/10/2007

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