Carl D Brown, D.O.
Individual provider Active NPI Neurology Physician · Odessa, TX
NPI 1104950658 · NPPES record last updated Sep 2, 2011
Key facts
- NPI
- 1104950658
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Neurology Physician 2084N0400X
- License
- F9245 (TX)
- Practice address
- 6100 Eastridge Rd
Odessa, TX 79762-5002 - Phone
- (432) 332-2858
- Fax
- (432) 333-3697
- NPI assigned
- Mar 15, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Hospital & facility affiliations 3
Medicare Care Compare profile
- Specialty
- Neurology
- Education
- Midwestern University, Chicago College of Osteopathic Med, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
8050 E Hwy 191
Suite 205
Odessa, TX 79765-8615
8050 E Hwy 191 205
Odessa, TX 79765-8615
Phone (432) 332-2858
Hospital & facility affiliations
- Medical Center Hospital
- Odessa Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110907001009 | TX | Practitioner - Neurology | 7113197864 | Practice locations: Odessa, TX |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F9245 | TX | MD | Neurology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ector County Hospital District | Past | Accepting new patients |
Interoperability endpoints
- cdbneuro@cdbd-tx.direct.office.nextgen.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Neurology Physician | 2084N0400X | F9245 | TX | Yes |
Addresses
Primary practice location
6100 Eastridge Rd
Odessa, TX 79762-5002
Mailing address
6100 Eastridge Rd
Odessa, TX 79762-5002
Phone (432) 332-2858
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 134900302 | Medicaid | TX |
Other providers in Odessa, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.