Provider Demographics
NPI:1396733556
Name:BROWN, TAYLOR DEWITT (MD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:DEWITT
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 1:6550 FANNIN ST
Mailing Address - Street 2:SUITE 2600
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2717
Mailing Address - Country:US
Mailing Address - Phone:713-790-1818
Mailing Address - Fax:713-790-7500
Practice Address - Street 1:6550 FANNIN ST
Practice Address - Street 2:SUITE 2600
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2717
Practice Address - Country:US
Practice Address - Phone:713-790-1818
Practice Address - Fax:713-790-7500
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2016-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3173207XX0005X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX189035201Medicaid
TX189035204Medicaid
TX5584550OtherCIGNA
TX8FE352OtherBLUE CROSS BLUE SHIELD
TX189035203Medicaid
TX8B5242OtherBCBS
P00352249OtherRR MEDICARE
TX189035202Medicaid
TX7113711OtherAETNA
TX8FX385OtherBLUE CROSS BLUE SHIELD
TX189035201Medicaid
TX436143ZSWDMedicare PIN
TX189035202Medicaid
TX436143YUD8Medicare PIN