Provider Demographics
NPI:1407067267
Name:MICHAEL D. BROWN, JR., D.O., PA
Entity Type:Organization
Organization Name:MICHAEL D. BROWN, JR., D.O., PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:JR
Authorized Official - Credentials:DO
Authorized Official - Phone:903-737-8808
Mailing Address - Street 1:1055 CLARKSVILLE ST
Mailing Address - Street 2:SUITE 155
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75460-6097
Mailing Address - Country:US
Mailing Address - Phone:903-737-8808
Mailing Address - Fax:903-737-8860
Practice Address - Street 1:1055 CLARKSVILLE ST
Practice Address - Street 2:SUITE 155
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75460-6097
Practice Address - Country:US
Practice Address - Phone:903-737-8808
Practice Address - Fax:903-737-8860
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2013-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM5650208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186218701Medicaid
TX00X728Medicare PIN
TXI74334Medicare UPIN