Provider Demographics
NPI:1801966684
Name:BROWN, DEBRA ANN (ST)
Entity type:Individual
Prefix:
First Name:DEBRA
Middle Name:ANN
Last Name:BROWN
Suffix:
Gender:F
Credentials:ST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 S FM 1194
Mailing Address - Street 2:
Mailing Address - City:LUFKIN
Mailing Address - State:TX
Mailing Address - Zip Code:75904-0740
Mailing Address - Country:US
Mailing Address - Phone:936-635-4598
Mailing Address - Fax:
Practice Address - Street 1:7622 N US HIGHWAY 69
Practice Address - Street 2:
Practice Address - City:POLLOK
Practice Address - State:TX
Practice Address - Zip Code:75969-4178
Practice Address - Country:US
Practice Address - Phone:936-853-2220
Practice Address - Fax:936-853-9321
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18185235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX138297OtherSUPERIOR CHIP
TX8T4236OtherBLUE CROSS BLUE SHIELD
TX172142501Medicaid