MEDICARE: KATHY BROOKE DROWN

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	320600000X	Intellectual and/or Developmental Disabilities Residential Treatment Facility
2	320700000X	Physical Disabilities Residential Treatment Facility

General Provider Information

NPI Number	:	1831332253
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY BROOKE DROWN

Provider Business Mailing Address
First Line	:	8531 LAKE CRYSTAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-3714
Country	:	US
Telephone Number	:	713-301-8637
Fax Number	:

Provider Business Practice Location Address
First Line	:	8531 LAKE CRYSTAL DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77095-3714
Country	:	US
Telephone Number	:	713-301-8637
Fax Number	:

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

Provider Enumeration Date	:	04/15/2009
Last Update Date	:	04/15/2009

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Directions to “ KATHY BROOKE DROWN ” Practice Location

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