Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | L8289 | TX |
NPI | 1093787194 |
---|---|
Provider Name | Katia V Brown |
First Address | Dallas, TX 75231-4407 |
Second Address | Dallas, TX 75231-4407 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2006 |
Last Update Date | 13/01/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
165303201 | (05) | TX |
165303205 | (05) | TX |
165303206 | (05) | TX |
8P4000 | BLUE CROSS BLUE SHIELD (01) | TX |
I06783 | (02) | TX |
P00269513 | RAILROAD MEDICARE (01) | TX |