Healthcare Provider Details

I. General information

NPI: 1053591883
Provider Name (Legal Business Name): LATANYA MARTIN BROWN HHP, RPSGT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/08/2007
Last Update Date: 08/11/2023
Certification Date: 08/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2742 LITTLE CANEY WAY
CONROE TX
77301-5086
US

IV. Provider business mailing address

303 LONGMIRE RD
CONROE TX
77304-2175
US

V. Phone/Fax

Practice location:
  • Phone: 831-817-3371
  • Fax:
Mailing address:
  • Phone: 832-952-1199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1710I1002X
TaxonomyIndependent Duty Corpsman
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: