MEDICARE: MS. ROXANNE VAN BROWN HIS

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	237700000X	Hearing Instrument Specialist	20243	TX

General Provider Information

NPI Number	:	1114142817
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ROXANNE VAN BROWN HIS

Provider Business Mailing Address
First Line	:	13785 RESEARCH BLVD STE 125
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1873
Country	:	US
Telephone Number	:	512-577-5027
Fax Number	:	512-991-9709

Provider Business Practice Location Address
First Line	:	13785 RESEARCH BLVD STE 125
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78750-1873
Country	:	US
Telephone Number	:	512-577-5027
Fax Number	:	512-991-9709

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

Provider Enumeration Date	:	04/16/2007
Last Update Date	:	03/06/2023

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