Provider Demographics
NPI:1770523821
Name:BROWN, CHANDRA L (MD)
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:L
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6124 W PARKER RD
Mailing Address - Street 2:MOB III SUITE 234
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75093-8124
Mailing Address - Country:US
Mailing Address - Phone:972-981-7500
Mailing Address - Fax:972-981-3600
Practice Address - Street 1:6124 W PARKER RD
Practice Address - Street 2:MOB III SUITE 234
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75093-8124
Practice Address - Country:US
Practice Address - Phone:972-981-7500
Practice Address - Fax:972-981-3600
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7510207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1487817151OtherGROUP NPI
TX0041MPOtherBCBS
8BL890OtherBCBS
TX1487817151OtherGROUP NPI
TX8F1982Medicare PIN
TXG90190Medicare UPIN
TX00Z533Medicare PIN