Provider Demographics
NPI:1083942007
Name:BROWN, LAYNE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LAYNE
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20602 ELDERWOOD TERRACE DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77406-1972
Mailing Address - Country:US
Mailing Address - Phone:713-819-1933
Mailing Address - Fax:
Practice Address - Street 1:18200 KATY FWY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77094-1285
Practice Address - Country:US
Practice Address - Phone:832-227-1620
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-02
Last Update Date:2015-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
363AS0400X
TXPA06543363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX210072902Medicaid
TXP10192498OtherRR MEDICARE
TX1083942007OtherBLUE CROSS BLUE SHIELD
TXP01031215OtherRR MEDICARE
TX210072903Medicaid
TX210072901Medicaid
TX210072904Medicaid
TX8L24632Medicare PIN
TX210072902Medicaid
TXTXB151212Medicare PIN
TX8L24631Medicare PIN