Provider Demographics
NPI:1417912080
Name:BROWNE, LARRY EUGENE (M D)
Entity Type:Individual
Prefix:MR
First Name:LARRY
Middle Name:EUGENE
Last Name:BROWNE
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 PARK ROAD 11 N
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:TX
Mailing Address - Zip Code:78629-5182
Mailing Address - Country:US
Mailing Address - Phone:830-875-8475
Mailing Address - Fax:830-875-2054
Practice Address - Street 1:200 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:TX
Practice Address - Zip Code:78648-3213
Practice Address - Country:US
Practice Address - Phone:830-875-8475
Practice Address - Fax:830-875-2054
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0410208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00AB17OtherBLUE CROSS BLUE SHIELD
TX0895476-01Medicaid
TXC13871Medicare UPIN
TX0895476-01Medicaid