Provider Demographics
NPI:1508409491
Name:BROWNLOW, MIKAYLA CATHERINE
Entity Type:Individual
Prefix:
First Name:MIKAYLA
Middle Name:CATHERINE
Last Name:BROWNLOW
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 1:417 W BYRD BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSAL CITY
Mailing Address - State:TX
Mailing Address - Zip Code:78148-4314
Mailing Address - Country:US
Mailing Address - Phone:210-739-8056
Mailing Address - Fax:
Practice Address - Street 1:417 W BYRD BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSAL CITY
Practice Address - State:TX
Practice Address - Zip Code:78148-4314
Practice Address - Country:US
Practice Address - Phone:210-739-8056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer