Healthcare Provider Details

I. General information

NPI: 1508671504
Provider Name (Legal Business Name): ZACHARY BROWN OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/08/2025
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7840 NATURAL BRIDGE RD
SAINT LOUIS MO
63121-4617
US

IV. Provider business mailing address

7840 NATURAL BRIDGE RD
SAINT LOUIS MO
63121-4617
US

V. Phone/Fax

Practice location:
  • Phone: 314-516-5131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2026028769
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: