Healthcare Provider Details

I. General information

NPI: 1376923748
Provider Name (Legal Business Name): JUDITH NGOZI BROWN D.O
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2015
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

810 W HIGHWAY 71
MARBLE FALLS TX
78654-8602
US

IV. Provider business mailing address

2401 S 31ST ST # MSARM200
TEMPLE TX
76508-0001
US

V. Phone/Fax

Practice location:
  • Phone: 254-724-2111
  • Fax: 630-978-6791
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number36148823
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberU8169
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: