Provider Demographics
NPI:1639384332
Name:TRICIA J BROWN MD
Entity Type:Organization
Organization Name:TRICIA J BROWN MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-477-0003
Mailing Address - Street 1:18220 STATE HIGHWAY 249
Mailing Address - Street 2:STE 270
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4347
Mailing Address - Country:US
Mailing Address - Phone:281-477-0003
Mailing Address - Fax:281-477-0004
Practice Address - Street 1:18220 STATE HIGHWAY 249
Practice Address - Street 2:STE 270
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4347
Practice Address - Country:US
Practice Address - Phone:281-477-0003
Practice Address - Fax:281-477-0004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2008-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7669207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0008QVOtherBLUE CROSS/BLUE SHIELD
TX0008QVOtherBLUE CROSS/BLUE SHIELD
TXDF7129Medicare PIN
TXH81382Medicare UPIN