Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | H3859 | TX |
N | 207QA0401X | Family Doctor - Addiction Medicine | H3859 | TX |
NPI | 1306887534 |
---|---|
Provider Name | Dr. William Clay Brown |
First Address | Houston, TX 77055-6516 |
Second Address | Winnie, TX 77665-9310 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2006 |
Last Update Date | 10/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0038MQ | BCBS GROUP NUMBER (01) | TX |
179381201 | (05) | TX |
8S2463 | BCBS INDIVIDUAL NUMBER (01) | TX |
I49921 | (02) | TX |