Provider Demographics
NPI:1013738780
Name:BROWN, ERYKAH A
Entity type:Individual
Prefix:
First Name:ERYKAH
Middle Name:A
Last Name:BROWN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4730 FAIRMOUNT ST APT 1318
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-1113
Mailing Address - Country:US
Mailing Address - Phone:817-707-8349
Mailing Address - Fax:
Practice Address - Street 1:1111 W MOCKINGBIRD LN
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75247-5028
Practice Address - Country:US
Practice Address - Phone:972-489-5552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator