MEDICARE: DR. MARY C BROWER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	H0236	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1083692750
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARY C BROWER

Provider Business Mailing Address
First Line	:	7500 VISCOUNT BLVD
Second Line	:	SUITE 140
City	:	EL PASO
State	:	TX
Zip	:	79925
Country	:	US
Telephone Number	:	915-790-5700
Fax Number	:	915-595-3916

Provider Business Practice Location Address
First Line	:	6600 NORTH DESERT BLVD
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79912
Country	:	US
Telephone Number	:	915-521-2200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2006
Last Update Date	:	12/16/2019

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