Individual
MARLO BRAWNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 OGLETREE DR, LIVINGSTON, TX 77351-6783
(936) 328-8812
(936) 328-8815
Mailing address
400 OGLETREE DR, LIVINSTON, TX 77351
(936) 328-8812
(936) 328-8815
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L6736
TX
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
L6736
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
159580303
—
TX
05
—
169920908
—
TX
05
—
169920909
—
TX
01
—
21239
CHOICE ONE CHIPS
TX
01
—
8P9491
BCBS NUMBER
TX
Enumeration date
09/21/2006
Last updated
05/01/2026
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