Provider Demographics
NPI:1295573186
Name:BROWN, LAWRENCE CORDELL (OTR/L)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:CORDELL
Last Name:BROWN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:697 FLAT SWAMP RD
Mailing Address - Street 2:
Mailing Address - City:BLOUNTS CREEK
Mailing Address - State:NC
Mailing Address - Zip Code:27814-9337
Mailing Address - Country:US
Mailing Address - Phone:252-495-2733
Mailing Address - Fax:
Practice Address - Street 1:1000 N COOPER ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76011-5540
Practice Address - Country:US
Practice Address - Phone:817-548-3400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX124601225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist