Provider Demographics
NPI:1518086743
Name:BROWN, DAVID WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:WARREN
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8334 CROSS PARK DR.
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78754-5122
Mailing Address - Country:US
Mailing Address - Phone:512-323-2622
Mailing Address - Fax:512-323-2625
Practice Address - Street 1:8334 CROSS PARK DR.
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78754-5122
Practice Address - Country:US
Practice Address - Phone:512-323-2622
Practice Address - Fax:512-323-2625
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH22672084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0989170-02Medicaid
TXJ48QMedicare ID - Type Unspecified
TX0989170-02Medicaid