Provider Demographics
NPI:1740640580
Name:BROWN, RUNSHAY (CERTIFIED MEDICAL AS)
Entity type:Individual
Prefix:
First Name:RUNSHAY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:CERTIFIED MEDICAL AS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9401 S 1ST ST
Mailing Address - Street 2:APT. 814
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-6744
Mailing Address - Country:US
Mailing Address - Phone:512-596-6929
Mailing Address - Fax:
Practice Address - Street 1:9401 S 1ST ST
Practice Address - Street 2:APT. 814
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6744
Practice Address - Country:US
Practice Address - Phone:512-596-6929
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-04
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX77641251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health