Provider Demographics
NPI:1073868782
Name:BROWN, DANIEL (PT)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3101 LANDOVER DR
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-3933
Mailing Address - Country:US
Mailing Address - Phone:214-232-7601
Mailing Address - Fax:
Practice Address - Street 1:1740 N COLLINS BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-3640
Practice Address - Country:US
Practice Address - Phone:972-644-6790
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-18
Last Update Date:2012-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1218312225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist