Healthcare Provider Details

I. General information

NPI: 1063591683
Provider Name (Legal Business Name): PHILIP M BROWN MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 GASTON AVE WADLEY #360
DALLAS TX
75246-1800
US

IV. Provider business mailing address

804 SCOTT NIXON MEMORIAL DR
AUGUSTA GA
30907-2464
US

V. Phone/Fax

Practice location:
  • Phone: 214-820-7246
  • Fax: 214-820-7497
Mailing address:
  • Phone: 800-394-4445
  • Fax: 706-434-8876

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateTX

VIII. Authorized Official

Name: DR. PHILIP M BROWN
Title or Position: OWNER
Credential: MD
Phone: 214-820-7246