Healthcare Provider Details

I. General information

NPI: 1821094384
Provider Name (Legal Business Name): MARGARET FAYE BROUWER R-EEG-T
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/21/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 W 15TH ST
PLANO TX
75093-5803
US

IV. Provider business mailing address

3330 EARHART DR STE 206
CARROLLTON TX
75006-4919
US

V. Phone/Fax

Practice location:
  • Phone: 972-985-0498
  • Fax: 972-599-1838
Mailing address:
  • Phone: 972-991-9950
  • Fax: 972-991-9548

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZE0500X
TaxonomyEEG Specialist/Technologist
License Number2199
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: