Provider Demographics
NPI:1053876235
Name:BROWN, TOMMY J (DO)
Entity type:Individual
Prefix:
First Name:TOMMY
Middle Name:J
Last Name:BROWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:NEDERLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77627-0421
Mailing Address - Country:US
Mailing Address - Phone:409-985-2450
Mailing Address - Fax:
Practice Address - Street 1:5030 HIGHWAY 69 S STE 700
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77705-1258
Practice Address - Country:US
Practice Address - Phone:409-726-2571
Practice Address - Fax:409-726-2569
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-01
Last Update Date:2019-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE2150207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology