Provider Demographics
NPI:1114095601
Name:BROWN, AYANNA JANELL (MD)
Entity Type:Individual
Prefix:DR
First Name:AYANNA
Middle Name:JANELL
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 1:19701 KINGWOOD DR
Mailing Address - Street 2:BLDG 3
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77339-3773
Mailing Address - Country:US
Mailing Address - Phone:281-358-5701
Mailing Address - Fax:281-358-7061
Practice Address - Street 1:19701 KINGWOOD DR
Practice Address - Street 2:BLDG 3
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-3773
Practice Address - Country:US
Practice Address - Phone:281-358-5701
Practice Address - Fax:281-358-7061
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-01
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN06632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX206065901Medicaid
TX45D2077598OtherCLIA
TX8L16515Medicare PIN