MEDICARE: WILLIAM GEORGE BROWN LPC

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	101YP2500X	Professional Counselor	65965	TX

General Provider Information

NPI Number	:	1861794455
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM GEORGE BROWN LPC

Provider Business Mailing Address
First Line	:	1423 COUNTY ROAD 4516
Second Line	:
City	:	CASTROVILLE
State	:	TX
Zip	:	78009-5548
Country	:	US
Telephone Number	:	210-488-4094
Fax Number	:

Provider Business Practice Location Address
First Line	:	3740 COLONY DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78230-2234
Country	:	US
Telephone Number	:	210-488-4094
Fax Number	:

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

Provider Enumeration Date	:	12/02/2010
Last Update Date	:	02/19/2020

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