Healthcare Provider Details

I. General information

NPI: 1831290592
Provider Name (Legal Business Name): NANCY KATHERINE BROWN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7400 MERTON MINTER ST 18A
SAN ANTONIO TX
78229-4404
US

IV. Provider business mailing address

334 DARTMOOR ST
SAN ANTONIO TX
78227-4309
US

V. Phone/Fax

Practice location:
  • Phone: 210-617-5215
  • Fax:
Mailing address:
  • Phone: 210-674-0760
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA02630
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: