Provider Demographics
NPI:1265467385
Name:BROWN, FARLEY W (DC, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:FARLEY
Middle Name:W
Last Name:BROWN
Suffix:
Gender:M
Credentials:DC, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 W RANDOL MILL RD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-3115
Mailing Address - Country:US
Mailing Address - Phone:817-274-2273
Mailing Address - Fax:817-261-8091
Practice Address - Street 1:1406 W RANDOL MILL RD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-3115
Practice Address - Country:US
Practice Address - Phone:817-274-2273
Practice Address - Fax:817-261-8091
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4204111N00000X
TX774091363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX08837903Medicaid
TXT12415Medicare UPIN
TX601601Medicare ID - Type Unspecified