Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | D85567 | MD |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | S4272 | TX |
NPI | 1558705632 |
---|---|
Provider Name | Ms. Lisa-Marie Camille Brown |
First Address | Pharr, TX 78577-1614 |
Second Address | Edinburg, TX 78539-5503 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2013 |
Last Update Date | 14/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D85567 | LICENSE (01) | MD |