Healthcare Provider Details

I. General information

NPI: 1851399398
Provider Name (Legal Business Name): THOMAS C. BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 CULLY DR STE B
KERRVILLE TX
78028-6084
US

IV. Provider business mailing address

PO BOX 26499
BELFAST ME
04915-2015
US

V. Phone/Fax

Practice location:
  • Phone: 830-896-6262
  • Fax: 830-896-6269
Mailing address:
  • Phone: 830-896-6262
  • Fax: 830-896-6269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberM7066
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: