Healthcare Provider Details

I. General information

NPI: 1699700740
Provider Name (Legal Business Name): ELIZABETH J. BROWN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 07/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5323 HARRY HINES BOULEVARD
DALLAS TX
75390-7201
US

IV. Provider business mailing address

P.O. BOX 845347
DALLAS TX
75284-5347
US

V. Phone/Fax

Practice location:
  • Phone: 214-456-2980
  • Fax: 214-456-8042
Mailing address:
  • Phone: 214-456-2980
  • Fax: 214-456-8042

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberP1971
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2080P0210X
TaxonomyPediatric Nephrology Physician
License NumberP1971
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: