Provider Demographics
NPI:1851071542
Name:BROWN, TANYA M (HIS)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:420 E ROUND GROVE RD STE 113
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8386
Mailing Address - Country:US
Mailing Address - Phone:972-459-2320
Mailing Address - Fax:
Practice Address - Street 1:420 E ROUND GROVE RD STE 113
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8386
Practice Address - Country:US
Practice Address - Phone:972-459-2320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-19
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX81030237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist