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Individual

AMANDA JANE BROWN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
3104 INDIANA AVE, LUBBOCK, TX 79410-3148
(806) 793-1927
(806) 791-4077
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
07231TG
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
L0160250
TEXAS CONTROLLED SUBSTANCES REGISTRATION CERTIFICATE
TX
Enumeration date
03/04/2009
Last updated
09/30/2021
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