Organization
LYLE L. BROWN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LYLE L BROWN M.D. (PRESIDENT)
(936) 559-0800
Entity
Organization
Contact information
Practice address
3316 N UNIVERSITY DR STE C, NACOGDOCHES, TX 75965-2607
(936) 559-0800
(936) 559-0803
Mailing address
4106 BELLE POINTE DR, NACOGDOCHES, TX 75965-4879
(903) 816-2400
(936) 559-0800
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013SH
BLUE CROSS BLUE SHIELD
TX
05
—
202036401
—
TX
01
—
DO8153
RAILROAD MEDICARE
TX
Enumeration date
03/27/2009
Last updated
01/18/2019
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