Provider Demographics
NPI:1871004879
Name:WAXAHACHIE WOMENS HEALTH
Entity Type:Organization
Organization Name:WAXAHACHIE WOMENS HEALTH
Other - Org Name:JASON P. BROWN, M.D., PLLC
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JASON
Authorized Official - Middle Name:P
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-938-3493
Mailing Address - Street 1:207 WILLIAMS ST
Mailing Address - Street 2:
Mailing Address - City:WAXAHACHIE
Mailing Address - State:TX
Mailing Address - Zip Code:75165-3447
Mailing Address - Country:US
Mailing Address - Phone:214-621-2066
Mailing Address - Fax:
Practice Address - Street 1:2800 E BROAD ST STE 212
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-6411
Practice Address - Country:US
Practice Address - Phone:214-621-2066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL2822207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32065031281OtherNEW TAX ID
TX149332202Medicaid
TX859410OtherBCBS