Provider Demographics
NPI:1326083643
Name:BROWN, KENDALL P (MD)
Entity Type:Individual
Prefix:
First Name:KENDALL
Middle Name:P
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2445 PINEBLUFF DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-5841
Mailing Address - Country:US
Mailing Address - Phone:254-230-2095
Mailing Address - Fax:
Practice Address - Street 1:2445 PINEBLUFF DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-5841
Practice Address - Country:US
Practice Address - Phone:254-230-2095
Practice Address - Fax:972-767-4744
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-19
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM98852084P0800X, 2084P0805X, 2084P0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0005XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurodevelopmental Disabilities
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry