Provider Demographics
NPI:1235338807
Name:LYNUS BROWN JR MD PA
Entity Type:Organization
Organization Name:LYNUS BROWN JR MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNUS
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD,
Authorized Official - Phone:512-358-7184
Mailing Address - Street 1:4534 WESTGATE BLVD. STE. 114
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745
Mailing Address - Country:US
Mailing Address - Phone:512-358-7184
Mailing Address - Fax:512-358-7188
Practice Address - Street 1:4534 WESTGATE BLVD. STE. 114
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745
Practice Address - Country:US
Practice Address - Phone:512-358-7184
Practice Address - Fax:512-358-7188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5426208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE33878OtherUPIN
TX1831297365OtherNPI
TX94EPOtherBCBS
TX4121630OtherAETNA
TXE33878OtherUPIN