Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | Q6310 | TX |
NPI | 1003159393 |
---|---|
Provider Name | Jessica Brown |
First Address | Arlington, TX 76012-4703 |
Second Address | Arlington, TX 76012-4703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2013 |
Last Update Date | 11/08/2017 |