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General NPI Number Information
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NPI Number | 1003110834
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Entity Type | Individual
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Provider Name | JUSTIN LEE BROWN D.P.M.
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Gender | Male
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Dates
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Enumeration Date | 01/09/2011
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Last Update Date | 04/17/2026
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Provider Practice Location Address
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Address Line | 420 E 6TH ST STE 104
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City | ODESSA
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State | TX
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Zip | 79761-4537
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Country | US
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Telephone | 732-614-1799
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Fax |
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Provider Business Mailing Address
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Address Line | 8135 FOREST LN # 515057
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City | DALLAS
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State | TX
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Zip | 75230-2472
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Country | US
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Telephone | 469-850-5760
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 2028
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License Number State | TX
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