Provider Demographics
NPI:1740960475
Name:BROWN, STEVEN MICHAEL
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:MICHAEL
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10707 CORPORATE DR STE 135
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-4090
Mailing Address - Country:US
Mailing Address - Phone:832-532-0129
Mailing Address - Fax:
Practice Address - Street 1:10707 CORPORATE DR STE 135
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-4090
Practice Address - Country:US
Practice Address - Phone:832-532-0129
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-18
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14662103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent