Provider Demographics
NPI:1346388519
Name:BROWN, PHILIP K (DDS)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:K
Last Name:BROWN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4775 W PANTHER CREEK DR
Mailing Address - Street 2:SUITE B265
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-3592
Mailing Address - Country:US
Mailing Address - Phone:281-419-2405
Mailing Address - Fax:
Practice Address - Street 1:4775 W PANTHER CREEK DR
Practice Address - Street 2:SUITE B265
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-3592
Practice Address - Country:US
Practice Address - Phone:281-419-2405
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX222921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice