Provider Demographics
NPI:1538308077
Name:BROWN, SAVANNAH (PA-C)
Entity Type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:
Last Name:BROWN
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 1:310 COMAL ST STE 200
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78702-4599
Mailing Address - Country:US
Mailing Address - Phone:737-270-9500
Mailing Address - Fax:833-906-2436
Practice Address - Street 1:310 COMAL ST STE 200
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78702-4599
Practice Address - Country:US
Practice Address - Phone:737-270-9500
Practice Address - Fax:833-906-2436
Is Sole Proprietor?:No
Enumeration Date:2009-02-06
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AS0400X
TXPA06069363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical