Provider Demographics
NPI:1922147933
Name:BROWN, GREGORY E (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:E
Last Name:BROWN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4360 GRECO DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-2725
Mailing Address - Country:US
Mailing Address - Phone:210-648-8200
Mailing Address - Fax:888-281-2809
Practice Address - Street 1:4360 GRECO DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78222-2725
Practice Address - Country:US
Practice Address - Phone:210-648-8200
Practice Address - Fax:855-392-7988
Is Sole Proprietor?:No
Enumeration Date:2007-02-06
Last Update Date:2021-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ6397207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXQ6397OtherTX LICENSE
TX481542YLM2Medicare PIN