Provider Demographics
NPI:1396859435
Name:BROWN, BERNADETTE M (MD)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:M
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:894 SUMMIT ST
Mailing Address - Street 2:SUITE 108
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78664-4322
Mailing Address - Country:US
Mailing Address - Phone:512-255-6033
Mailing Address - Fax:512-255-1150
Practice Address - Street 1:894 SUMMIT ST
Practice Address - Street 2:SUITE 108
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664-4322
Practice Address - Country:US
Practice Address - Phone:512-255-6033
Practice Address - Fax:512-255-1150
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
TXF6480208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE81294Medicare UPIN