Provider Demographics
NPI:1932437241
Name:BROWN, GRAHAM B (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:GRAHAM
Middle Name:B
Last Name:BROWN
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12700 TIERRA ALEXIS DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-5369
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:212 CARPENTERS UNION WAY STE 500
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89119-4231
Practice Address - Country:US
Practice Address - Phone:844-370-6205
Practice Address - Fax:866-268-5209
Is Sole Proprietor?:No
Enumeration Date:2009-11-24
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX48129183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX48129OtherTEXAS STATE BOARD OF PHARMACY