MEDICARE: DR. RAY HALLUM BROWN M.D.

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	207Q00000X	Family Medicine Physician	H3858	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	H3858	OTHER	TX	LICENSE NUMBER

General Provider Information

NPI Number	:	1326367202
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAY HALLUM BROWN M.D.

Provider Business Mailing Address
First Line	:	9622 WEBB CHAPEL RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75220-4940
Country	:	US
Telephone Number	:	214-358-3601
Fax Number	:

Provider Business Practice Location Address
First Line	:	9622 WEBB CHAPEL RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75220-4940
Country	:	US
Telephone Number	:	214-358-3601
Fax Number	:	214-358-3639

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

Provider Enumeration Date	:	05/18/2010
Last Update Date	:	03/29/2011

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