MEDICARE: VANESSA BROWN

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	103TH0100X	Health Service Psychologist		TX

General Provider Information

NPI Number	:	1245174945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VANESSA BROWN

Provider Business Mailing Address
First Line	:	11111 WOODMEADOW PKWY APT 1928
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-7320
Country	:	US
Telephone Number	:	214-744-5357
Fax Number	:

Provider Business Practice Location Address
First Line	:	11111 WOODMEADOW PKWY APT 1928
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-7320
Country	:	US
Telephone Number	:	214-744-5357
Fax Number	:

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

Provider Enumeration Date	:	04/15/2026
Last Update Date	:	04/15/2026

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Directions to “ VANESSA BROWN ” Practice Location

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