MEDICARE: ABBY CELESTE BROWN MD

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	390200000X	Student in an Organized Health Care Education/Training Program
2	208000000X	Pediatrics Physician	T6841	TX

General Provider Information

NPI Number	:	1922664861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABBY CELESTE BROWN MD

Provider Business Mailing Address
First Line	:	140 HARRIETT DR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-7302
Country	:	US
Telephone Number	:	940-632-6886
Fax Number	:

Provider Business Practice Location Address
First Line	:	11930 W US HIGHWAY 90 STE 110
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78245-9613
Country	:	US
Telephone Number	:	210-233-7000
Fax Number	:	210-431-4940

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

Provider Enumeration Date	:	05/16/2019
Last Update Date	:	08/14/2023

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