Healthcare Provider Details

I. General information

NPI: 1962864231
Provider Name (Legal Business Name): ALLISON JOAN LOUIS BROWN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2016
Last Update Date: 05/03/2024
Certification Date: 05/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

141 INDUSTRIAL AVE
AZLE TX
76020-2901
US

IV. Provider business mailing address

200 W MAGNOLIA AVE STE 201
FORT WORTH TX
76104-7657
US

V. Phone/Fax

Practice location:
  • Phone: 817-444-3231
  • Fax:
Mailing address:
  • Phone: 817-702-2977
  • Fax: 817-702-2140

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR8046
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: