Provider Demographics
NPI:1407815228
Name:BROWN, KENDALL O (MD)
Entity Type:Individual
Prefix:DR
First Name:KENDALL
Middle Name:O
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7610 N STEMMONS FWY STE 600
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-4228
Mailing Address - Country:US
Mailing Address - Phone:214-689-5960
Mailing Address - Fax:469-713-8084
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:SUITE B304
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2505
Practice Address - Country:US
Practice Address - Phone:972-566-8844
Practice Address - Fax:469-713-8037
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH16902080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX83Y799OtherBCBSTX
TX83Y799OtherBCBSTX
TXE51562Medicare UPIN
TX83Y799Medicare PIN