Provider Demographics
NPI:1497023584
Name:BROWNE, GLORIA JEAN (COTA)
Entity Type:Individual
Prefix:
First Name:GLORIA
Middle Name:JEAN
Last Name:BROWNE
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5005 THUNDERBIRD ST
Mailing Address - Street 2:
Mailing Address - City:LAGO VISTA
Mailing Address - State:TX
Mailing Address - Zip Code:78645-6063
Mailing Address - Country:US
Mailing Address - Phone:512-423-0565
Mailing Address - Fax:
Practice Address - Street 1:2333 MANOR DR
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-1907
Practice Address - Country:US
Practice Address - Phone:979-821-7330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX211409225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist