Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2082S0105X | Plastic Hand Surgeon | Q4050 | TX |
NPI | 1316189921 |
---|---|
Provider Name | Matthew Steven Brown |
First Address | Odessa, TX 79765-2542 |
Second Address | Odessa, TX 79765-2542 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2009 |
Last Update Date | 09/12/2021 |