Provider Demographics
NPI:1003853011
Name:BROWN, BEIL CORY (DPM)
Entity Type:Individual
Prefix:
First Name:BEIL
Middle Name:CORY
Last Name:BROWN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5409
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79608-5409
Mailing Address - Country:US
Mailing Address - Phone:325-793-5135
Mailing Address - Fax:325-793-5218
Practice Address - Street 1:1665 ANTILLEY RD., SUITE 210
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5223
Practice Address - Country:US
Practice Address - Phone:325-793-5135
Practice Address - Fax:325-793-5136
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2019-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1665213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
4791770001Medicare NSC
TX8L0794Medicare PIN
TXU96516Medicare UPIN