Organization
LIBERTY MEDICAL SURGICAL CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ARTHUR REESE BROWN M.D. (OWNER/PARTNER)
(936) 336-6439
Entity
Organization
Contact information
Practice address
720 TRAVIS ST, LIBERTY, TX 77575-4828
(936) 336-6439
(936) 336-6517
Mailing address
720 TRAVIS ST, LIBERTY, TX 77575-4828
(936) 336-6439
(936) 336-6517
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
45D0497236
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
093702101
—
TX
01
—
1159730001
DMERC
TX
01
—
CH8298
RR MEDICARE-NR
TX
Enumeration date
07/07/2005
Last updated
05/02/2011
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