Provider Demographics
NPI:1043233745
Name:BROWN, BYRON L (MD)
Entity Type:Individual
Prefix:DR
First Name:BYRON
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 650252
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75265-0252
Mailing Address - Country:US
Mailing Address - Phone:806-799-1485
Mailing Address - Fax:806-799-8132
Practice Address - Street 1:3508 22ND PL
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1316
Practice Address - Country:US
Practice Address - Phone:806-799-1485
Practice Address - Fax:806-799-8132
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6481207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX136166902Medicaid
TXC13858Medicare UPIN
TX89V770Medicare PIN
TX136166902Medicaid