MEDICARE: NICOLE HALL BROWN DPT, OCS, SCS, TPS

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	225100000X	Physical Therapist	1188815	TX

General Provider Information

NPI Number	:	1700011038
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE HALL BROWN DPT, OCS, SCS, TPS

Provider Business Mailing Address
First Line	:	590 MEDICAL CENTER ROAD
Second Line	:
City	:	FT CAVAZOS
State	:	TX
Zip	:	76544
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	590 MEDICAL CENTER ROAD
Second Line	:
City	:	FT CAVAZOS
State	:	TX
Zip	:	76544
Country	:	US
Telephone Number	:	830-822-5834
Fax Number	:

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

Provider Enumeration Date	:	05/15/2009
Last Update Date	:	10/31/2024

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