Provider Demographics
NPI:1578614715
Name:BROWN, DEAN PAUL (DO)
Entity Type:Individual
Prefix:DR
First Name:DEAN
Middle Name:PAUL
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2909 S GEORGIA ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79109-3436
Mailing Address - Country:US
Mailing Address - Phone:806-359-3139
Mailing Address - Fax:806-359-3130
Practice Address - Street 1:2909 S GEORGIA ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79109-3436
Practice Address - Country:US
Practice Address - Phone:806-359-3139
Practice Address - Fax:806-359-3130
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG3187207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00GC11OtherBLUE CROSS BLUE SHIELD
TX751993100791090000OtherTRICARE
TX098581401Medicaid
TXD75101Medicare UPIN
TX00GC11Medicare ID - Type Unspecified