Provider Demographics
NPI:1528205580
Name:BROWN-BRYANT, SANDRA LEE
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:LEE
Last Name:BROWN-BRYANT
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 1:7633 BECKWOOD DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-6051
Mailing Address - Country:US
Mailing Address - Phone:817-939-8939
Mailing Address - Fax:817-492-8262
Practice Address - Street 1:7633 BECKWOOD DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-6051
Practice Address - Country:US
Practice Address - Phone:817-939-8939
Practice Address - Fax:817-492-8262
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator