Provider Demographics
NPI:1154440691
Name:BROWN, FREDERICK PHILIP (DDS)
Entity Type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:PHILIP
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9554 MAJESTIC OAK CIR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78255-3449
Mailing Address - Country:US
Mailing Address - Phone:210-698-0431
Mailing Address - Fax:
Practice Address - Street 1:1406 FITCH ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78211-1406
Practice Address - Country:US
Practice Address - Phone:210-922-2446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX143881223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health