Provider Demographics
NPI:1700917580
Name:BROWN, INGRID (MD)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1490 RUSK RD.
Mailing Address - Street 2:STE. 202
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-3306
Mailing Address - Country:US
Mailing Address - Phone:512-255-7762
Mailing Address - Fax:512-255-7761
Practice Address - Street 1:4112 LINKS LANE SUITE 205
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78664
Practice Address - Country:US
Practice Address - Phone:512-255-7762
Practice Address - Fax:866-571-3565
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2019-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA050944207V00000X
TXM7062207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H58869Medicare UPIN