Provider Demographics
NPI:1598117178
Name:BROWN, MEGAN (CHHC)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:CHHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4509 AVENUE G
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751-3116
Mailing Address - Country:US
Mailing Address - Phone:214-282-7409
Mailing Address - Fax:
Practice Address - Street 1:4509 AVENUE G
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751-3116
Practice Address - Country:US
Practice Address - Phone:214-282-7409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX49133007132700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes132700000XDietary & Nutritional Service ProvidersDietary Manager