Renaurd Brown
Individual provider Active NPI Physical Therapy Assistant · Orange, TX
NPI 1831500149 · NPPES record last updated May 9, 2014
Key facts
- NPI
- 1831500149
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 2086860 (TX)
- Practice address
- 4201 FM 105
Orange, TX 77630-1272 - Phone
- (409) 883-8803
- Fax
- (409) 883-8803
- NPI assigned
- May 9, 2014
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A7698 | LA | MD | Physical Therapy Assistant |
| 2086860 | TX | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 2086860 | TX | Yes |
| Physical Therapy Assistant | 225200000X | A7698 | LA |
Addresses
Primary practice location
4201 FM 105
Orange, TX 77630-1272
Mailing address
2205 Woodlawn St
Deridder, LA 70634-2112
Other providers in Orange, TX
- Brewer Dental PLLC
- Bright Branch ABA, LLC
- Bright Futures Pediatric Therapy
- Marilee Katherine Brinson
- Darla Brister
- Sally W Burman
- Makenzie Rose Callender
- Mary Cannatella
- Philip Martinez Cantu
- Simon David Castaneda
All providers in Orange, TX · Physical Therapy Assistant in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 9, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.