Provider Demographics
NPI:1952304974
Name:BROWN, HERBERT CLEIGHTON (MD)
Entity Type:Individual
Prefix:
First Name:HERBERT
Middle Name:CLEIGHTON
Last Name:BROWN
Suffix:
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 1:5605 N MACARTHUR BLVD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038-2617
Mailing Address - Country:US
Mailing Address - Phone:972-714-0007
Mailing Address - Fax:972-714-0009
Practice Address - Street 1:5605 N MACARTHUR BLVD
Practice Address - Street 2:SUITE 220
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-2617
Practice Address - Country:US
Practice Address - Phone:972-714-0007
Practice Address - Fax:972-714-0009
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5688207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX167848401Medicaid
TX167848401Medicaid
TXI10501Medicare UPIN