Healthcare Provider Details

I. General information

NPI: 1063432797
Provider Name (Legal Business Name): TIMOTHY CHARLES ANDREW BROWN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 05/25/2022
Certification Date: 05/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1610 LANSING LN
LEAGUE CITY TX
77573-7080
US

IV. Provider business mailing address

1610 LANSING LN
LEAGUE CITY TX
77573-7080
US

V. Phone/Fax

Practice location:
  • Phone: 516-360-3531
  • Fax: 888-581-9071
Mailing address:
  • Phone: 516-360-3531
  • Fax: 888-581-9071

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number135124
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number135124
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberR9725
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: