Provider Demographics
NPI:1851569024
Name:BROWN FAMILY HEALTH CENTER INC
Entity Type:Organization
Organization Name:BROWN FAMILY HEALTH CENTER INC
Other - Org Name:HEALTH HORIZONS OF EAST TEXAS, INC.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:YOLANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:TATUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-569-8240
Mailing Address - Street 1:PO BOX 635022
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75963-5022
Mailing Address - Country:US
Mailing Address - Phone:936-569-8240
Mailing Address - Fax:936-569-2217
Practice Address - Street 1:1407 E MAIN ST
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-5369
Practice Address - Country:US
Practice Address - Phone:936-569-8240
Practice Address - Fax:936-569-2217
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
673932OtherMEDICARE CCN
TX182721401Medicaid
TX0092SGOtherBLUE CROSS BLUE SHIELD
TXOA3760Medicare PIN
TX00686TMedicare PIN