Provider Demographics
NPI:1831297365
Name:BROWN, LYNUS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LYNUS
Middle Name:
Last Name:BROWN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5415 MOUNTAIN CEDAR CV
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4503
Mailing Address - Country:US
Mailing Address - Phone:512-358-7184
Mailing Address - Fax:
Practice Address - Street 1:4534 W GATE BLVD STE 114
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-1468
Practice Address - Country:US
Practice Address - Phone:512-358-7184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH5426207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE33878Medicare UPIN