Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | 553840 | TX |
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 553840 | TX |
NPI | 1003834292 |
---|---|
Provider Name | Jeri Swaim Brown |
First Address | Dallas, TX 75284-6098 |
Second Address | Whitehouse, TX 75791-3037 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 15/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
142068907 | (05) | TX |
75-0818167-022 | TRICARE (01) | TX |
75-2616977-002 | TRICARE (01) | TX |
752616977023 | TRICARE (01) | TX |
75-2616977-028 | TRICARE (01) | TX |
75-2616977-129 | TRICARE (01) | TX |
810N87 | BCBS (01) | TX |
8617NP | BCBS (01) | TX |
P01470490 | RAIL ROAD MEDICARE (01) | TX |
S87579 | (02) |