Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | M5649 | TX |
NPI | 1003947870 |
---|---|
Provider Name | Kevin H. Brown |
First Address | Round Rock, TX 78665-3306 |
Second Address | Round Rock, TX 78665-3306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/03/2007 |
Last Update Date | 15/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H58870 | (02) |