Healthcare Provider Details

I. General information

NPI: 1750285581
Provider Name (Legal Business Name): TIMETRA BROWN APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17580 INTERSTATE 45 S
CONROE TX
77384-4972
US

IV. Provider business mailing address

1333 OLD SPANISH TRL STE G181
HOUSTON TX
77054-1849
US

V. Phone/Fax

Practice location:
  • Phone: 936-267-5000
  • Fax:
Mailing address:
  • Phone: 832-583-0042
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number41415
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: