Provider Demographics
NPI:1093102501
Name:BROWN, JULIA PENELOPE (PT)
Entity Type:Individual
Prefix:MRS
First Name:JULIA
Middle Name:PENELOPE
Last Name:BROWN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 W LAMPASAS ST
Mailing Address - Street 2:
Mailing Address - City:ENNIS
Mailing Address - State:TX
Mailing Address - Zip Code:75119-5644
Mailing Address - Country:US
Mailing Address - Phone:972-875-0900
Mailing Address - Fax:469-256-2341
Practice Address - Street 1:2201 W LAMPASAS ST
Practice Address - Street 2:
Practice Address - City:ENNIS
Practice Address - State:TX
Practice Address - Zip Code:75119-5644
Practice Address - Country:US
Practice Address - Phone:972-875-0900
Practice Address - Fax:469-256-2341
Is Sole Proprietor?:No
Enumeration Date:2015-04-22
Last Update Date:2015-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1065506225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist