Provider Demographics
NPI:1205024734
Name:FORREST C. BROWN MD,PA
Entity Type:Organization
Organization Name:FORREST C. BROWN MD,PA
Other - Org Name:CONSULTING DERMATOLOGIC SPECIALISTS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:FORREST
Authorized Official - Middle Name:C
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-566-4538
Mailing Address - Street 1:7777 FOREST LN
Mailing Address - Street 2:SUITE C-828
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-2505
Mailing Address - Country:US
Mailing Address - Phone:972-566-4537
Mailing Address - Fax:972-566-6018
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE C-828
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-4537
Practice Address - Fax:972-566-6018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-10
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD3169174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0841181-01Medicaid
TX00N25JMedicare PIN
TXC13855Medicare UPIN