Provider Demographics
NPI:1093782401
Name:BROWN, RAYMOND C JR (MD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:C
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14800 LANDMARK BLVD
Mailing Address - Street 2:SUITE 700
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7565
Mailing Address - Country:US
Mailing Address - Phone:972-391-1915
Mailing Address - Fax:
Practice Address - Street 1:900 W RANDOL MILL RD
Practice Address - Street 2:SUITE 206
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-2562
Practice Address - Country:US
Practice Address - Phone:817-461-8327
Practice Address - Fax:817-275-2525
Is Sole Proprietor?:No
Enumeration Date:2006-03-03
Last Update Date:2008-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9192208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX117858401Medicaid
TX117858401Medicaid
TX8293K3Medicare PIN