=====================================================
General NPI Number Information
=====================================================
NPI Number | 1588995070
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BROWDER CLINIC, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/22/2010
-----------------------------------------------------
Last Update Date | 01/22/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7005 WOODWAY DR SUITE 201
-----------------------------------------------------
City | WACO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76712-6169
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-732-3633
-----------------------------------------------------
Fax | 254-732-3661
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7005 WOODWAY DR SUITE 201
-----------------------------------------------------
City | WACO
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 76712-6169
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 254-732-3633
-----------------------------------------------------
Fax | 254-732-3661
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR
-----------------------------------------------------
Name | DR. JOSEPH BOND BROWDER
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 254-732-3633
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | E8356
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------