=====================================================
General NPI Number Information
=====================================================
NPI Number | 1750285581
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | TIMETRA BROWN APRN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/05/2026
-----------------------------------------------------
Last Update Date | 10/05/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 17580 INTERSTATE 45 S
-----------------------------------------------------
City | CONROE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77384-4972
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 936-267-5000
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1333 OLD SPANISH TRL STE G181
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77054-1849
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-583-0042
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | 41415
-----------------------------------------------------
License Number State | TN
-----------------------------------------------------