Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | H4247 | TX |
N | 207ND0101X | MOHS-Micrographic Surgeon | H4247 | TX |
N | 207ND0900X | Dermatopathologist | H4247 | TX |
N | 207NS0135X | Procedural Dermatology | H4247 | TX |
NPI | 1063460715 |
---|---|
Provider Name | Christine Dunham Brown |
First Address | Dallas, TX 75246 |
Second Address | Dallas, TX 75246 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 14/03/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
115604402 | (05) | TX |
E68977 | (02) | TX |