Individual
BETTY BROWN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
300 JOSEPH AVE, HENDERSON, TX 75654-4334
(903) 658-4855
(903) 392-8915
Mailing address
300 JOSEPH AVE, HENDERSON, TX 75654-4334
(903) 658-4855
(903) 392-8915
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
126482
TX
311ZA0620X
Adult Care Home Facility
Primary
126482
TX
311ZA0620X
Adult Care Home Facility
—
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
505489714
—
TX
Enumeration date
02/26/2016
Last updated
10/04/2021
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