MEDICARE: BERTRAND J BROWN JR. M.D.

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	207L00000X	Anesthesiology Physician	M2912	TX

General Provider Information

NPI Number	:	1912938580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BERTRAND J BROWN JR. M.D.

Provider Business Mailing Address
First Line	:	PO BOX 650002
Second Line	:	DEPT 8011
City	:	DALLAS
State	:	TX
Zip	:	75265-0002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7557 RAMBLER RD
Second Line	:	SUITE 706
City	:	DALLAS
State	:	TX
Zip	:	75231-2320
Country	:	US
Telephone Number	:	214-369-0800
Fax Number	:

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

Provider Enumeration Date	:	07/05/2006
Last Update Date	:	07/12/2007

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