Provider Demographics
NPI:1326214560
Name:BROWN, WADE L (MS, CCA-A)
Entity Type:Individual
Prefix:
First Name:WADE
Middle Name:L
Last Name:BROWN
Suffix:
Gender:M
Credentials:MS, CCA-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11439 SPRING CYPRESS RD UNIT B
Mailing Address - Street 2:
Mailing Address - City:TOMBALL
Mailing Address - State:TX
Mailing Address - Zip Code:77377-6513
Mailing Address - Country:US
Mailing Address - Phone:936-273-4437
Mailing Address - Fax:936-273-3279
Practice Address - Street 1:201 N HOUSTON ST
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:TX
Practice Address - Zip Code:77488-3821
Practice Address - Country:US
Practice Address - Phone:936-273-4437
Practice Address - Fax:936-273-3279
Is Sole Proprietor?:No
Enumeration Date:2008-05-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX51157231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX51157OtherLICENSE
81788AOtherBCBS
TXTXB153910OtherMEDICARE