Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 20164 | TX |
NPI | 1003996836 |
---|---|
Provider Name | Dr. Monica D Brown |
First Address | College Station, TX 77840 |
Second Address | College Station, TX 77840 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/10/2006 |
Last Update Date | 08/07/2007 |