MEDICARE: MR. ELROY JAMES BROWN II LCSW

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	1041C0700X	Clinical Social Worker	52174	TX

General Provider Information

NPI Number	:	1871918839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ELROY JAMES BROWN II LCSW

Provider Business Mailing Address
First Line	:	PO BOX 769699
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78245-9358
Country	:	US
Telephone Number	:	210-420-8168
Fax Number	:	210-346-1988

Provider Business Practice Location Address
First Line	:	10434 BRANCH POST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78245-2436
Country	:	US
Telephone Number	:	210-420-8168
Fax Number	:	210-346-1988

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

Provider Enumeration Date	:	02/28/2014
Last Update Date	:	12/16/2021

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