Individual
LYLE L. BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3316 N UNIVERSITY DR STE C, NACOGDOCHES, TX 75965-2607
(936) 559-0800
(936) 559-0803
Mailing address
3316 N UNIVERSITY DR STE C, NACOGDOCHES, TX 75965-2607
(936) 559-0800
(936) 559-0803
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
E5017
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116097006
—
TX
05
—
116097007
—
TX
01
—
75260358175090D019
TRICARE
TX
01
—
8A9266
BLUE CROSS BLUE SHIELD
TX
01
—
8BZ666
BLUE CROSS BLUE SHIELD
TX
01
—
P00185417
RAILROAD MEDICARE
TX
01
—
P00708949
RAILROAD MEDICARE
TX
Enumeration date
07/13/2006
Last updated
12/03/2018
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