Provider Demographics
NPI:1770718215
Name:BROWN, JEANIE MARIE (RT(R) ARRT)
Entity type:Individual
Prefix:MRS
First Name:JEANIE
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:RT(R) ARRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4136 HOWARD DR
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-3656
Mailing Address - Country:US
Mailing Address - Phone:469-667-8563
Mailing Address - Fax:
Practice Address - Street 1:4136 HOWARD DR
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-3656
Practice Address - Country:US
Practice Address - Phone:469-667-8563
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23402247100000X
TX346401247100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247100000XTechnologists, Technicians & Other Technical Service ProvidersRadiologic Technologist