Provider Demographics
NPI:1477615649
Name:BROWNING, MARY ANN (PA-C)
Entity Type:Individual
Prefix:
First Name:MARY ANN
Middle Name:
Last Name:BROWNING
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 ROLLINGBROOK DR STE 508
Mailing Address - Street 2:
Mailing Address - City:BAYTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:77521-3846
Mailing Address - Country:US
Mailing Address - Phone:618-985-9140
Mailing Address - Fax:618-985-9143
Practice Address - Street 1:1300 ROLLINGBROOK DR STE 508
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-3846
Practice Address - Country:US
Practice Address - Phone:618-985-9140
Practice Address - Fax:281-837-6463
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2018-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL085-000593363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
S45439Medicare UPIN