MEDICARE: PHILLIP CHARLES BROWN

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	332B00000X	Durable Medical Equipment & Medical Supplies	0104586	TX

General Provider Information

NPI Number	:	1851554638
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHILLIP CHARLES BROWN

Provider Business Mailing Address
First Line	:	6610 HARWIN DR
Second Line	:	STE 208
City	:	HOUSTON
State	:	TX
Zip	:	77036-2232
Country	:	US
Telephone Number	:	713-783-2749
Fax Number	:	713-783-2535

Provider Business Practice Location Address
First Line	:	6610 HARWIN DR
Second Line	:	STE 208
City	:	HOUSTON
State	:	TX
Zip	:	77036-2232
Country	:	US
Telephone Number	:	713-783-2749
Fax Number	:	713-783-2535

Authorized Official
Title or Position	:	OWNER
Name	:	PHILLIP CHARLES BROWN
Credential	:
Telephone Number	:	713-783-2749

Provider Enumeration Date	:	07/02/2008
Last Update Date	:	07/02/2008

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