=====================================================
General NPI Number Information
=====================================================
NPI Number | 1194805283
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BROWNWOOD CLINIC PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/16/2006
-----------------------------------------------------
Last Update Date | 09/11/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 B SOUTH PARK DRIVE
-----------------------------------------------------
City | BROWNWOOD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-646-3502
-----------------------------------------------------
Fax | 325-643-6567
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 101 B SOUTH PARK DRIVE
-----------------------------------------------------
City | BROWNWOOD
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 325-646-3502
-----------------------------------------------------
Fax | 325-643-6567
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | CHRISTOPHER GIST STEPHENS
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 325-646-3502
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RR0500X
-----------------------------------------------------
Taxonomy Name | Rheumatology Physician
-----------------------------------------------------
License Number | G0551
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number | H0244
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------