Provider Demographics
NPI:1093787194
Name:BROWN, KATIA V (MD)
Entity Type:Individual
Prefix:
First Name:KATIA
Middle Name:V
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8230 WALNUT HILL LN STE 308
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4407
Mailing Address - Country:US
Mailing Address - Phone:214-691-8306
Mailing Address - Fax:214-691-3967
Practice Address - Street 1:8230 WALNUT HILL LN STE 308
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4407
Practice Address - Country:US
Practice Address - Phone:214-691-8306
Practice Address - Fax:214-691-3967
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL8289207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX165303205Medicaid
TXP00269513OtherRAILROAD MEDICARE
TX165303206Medicaid
TX165303201Medicaid
TX8P4000OtherBLUE CROSS BLUE SHIELD
TX165303205Medicaid
TX165303206Medicaid
TX311697YKP5Medicare PIN