Provider Demographics
NPI:1700023249
Name:BROWN, SHANNON
Entity Type:Individual
Prefix:
First Name:SHANNON
Middle Name:
Last Name:BROWN
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 1:10965 S GESSNER DR
Mailing Address - Street 2:#2011
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77071-3500
Mailing Address - Country:US
Mailing Address - Phone:817-925-8028
Mailing Address - Fax:713-988-5755
Practice Address - Street 1:10965 S GESSNER DR
Practice Address - Street 2:#2011
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77071-3500
Practice Address - Country:US
Practice Address - Phone:817-925-8028
Practice Address - Fax:713-988-5755
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-20
Last Update Date:2011-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator