Provider Demographics
NPI:1093946436
Name:CHRISTINE D BROWN, MD, PA
Entity Type:Organization
Organization Name:CHRISTINE D BROWN, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-828-0016
Mailing Address - Street 1:PO BOX 674070
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75267-4070
Mailing Address - Country:US
Mailing Address - Phone:214-828-0016
Mailing Address - Fax:214-828-4883
Practice Address - Street 1:3600 GASTON AVE
Practice Address - Street 2:BARNETT TOWER, STE 901
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246
Practice Address - Country:US
Practice Address - Phone:214-828-0016
Practice Address - Fax:214-828-4883
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-03
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4247207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX115604402Medicaid
TX00N89HMedicare PIN
TXE68977Medicare UPIN