Healthcare Provider Details

I. General information

NPI: 1881122182
Provider Name (Legal Business Name): MATTHEW BROWN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2017
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PSC 475 BOX 1
FPO AP
96350-1200
US

IV. Provider business mailing address

PSC 475 BOX 1
FPO AP
96350-1200
US

V. Phone/Fax

Practice location:
  • Phone: 817-733-7600
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3120915
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: