Provider Demographics
NPI:1417660499
Name:BROWN, ELIZA S
Entity Type:Individual
Prefix:
First Name:ELIZA
Middle Name:S
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 S CROWLEY RD # SET9
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:TX
Mailing Address - Zip Code:76036-3639
Mailing Address - Country:US
Mailing Address - Phone:318-402-5644
Mailing Address - Fax:
Practice Address - Street 1:901 S CROWLEY RD # SET9
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:TX
Practice Address - Zip Code:76036-3639
Practice Address - Country:US
Practice Address - Phone:318-402-5644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-04
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy