MEDICARE: LAUREN BROWNFIELD, DDS, MS, PA

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	1223P0300X	Periodontics	23484	TX

General Provider Information

NPI Number	:	1891089488
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAUREN BROWNFIELD, DDS, MS, PA

Provider Business Mailing Address
First Line	:	1407 SOUTHMORE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77004-5845
Country	:	US
Telephone Number	:	713-790-0288
Fax Number	:	713-790-0289

Provider Business Practice Location Address
First Line	:	6410 FANNIN ST
Second Line	:	SUITE 1512
City	:	HOUSTON
State	:	TX
Zip	:	77030-3000
Country	:	US
Telephone Number	:	713-790-0288
Fax Number	:	713-790-0289

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. LAUREN BROWNFIELD
Credential	:	DDS, MS
Telephone Number	:	713-790-0288

Provider Enumeration Date	:	06/01/2011
Last Update Date	:	06/01/2011

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