Provider Demographics
NPI:1912167909
Name:LEWIS A BROWNE MD PA
Entity Type:Organization
Organization Name:LEWIS A BROWNE MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LEWIS
Authorized Official - Middle Name:A
Authorized Official - Last Name:BROWNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:903-236-4111
Mailing Address - Street 1:205 FOUNTAIN BLEAU AVE
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-4730
Mailing Address - Country:US
Mailing Address - Phone:903-235-8181
Mailing Address - Fax:
Practice Address - Street 1:3204 N 4TH ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5143
Practice Address - Country:US
Practice Address - Phone:903-236-4111
Practice Address - Fax:903-236-4112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-12
Last Update Date:2024-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF6485207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDN8586OtherMEDICARE RAILROAD
TX00AD08OtherBLUE CROSS BLUE SHIELD
TX0073RQOtherBLUE CROSS
TX00AD08Medicare PIN
TXDN8586OtherMEDICARE RAILROAD
TX00AD08OtherBLUE CROSS BLUE SHIELD