Individual provider Active NPI

Terry Lennell Brown, HUB CERTIFIED

  • Contractor
  • Beaumont, TX
National Provider Identifier
1861736035
Registry record updated Nov 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ContractorTaxonomy code 171W00000X
Practice address
3115 Washington Blvd
Beaumont, TX 77705-1359
Phone
(409) 842-5005
Fax
(888) 503-0567
NPI assigned
Nov 12, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Contractor 171W00000X TX Primary

Addresses

Primary practice location

3115 Washington Blvd
Beaumont, TX 77705-1359

Mailing address

6487 Tahoe Dr
Beaumont, TX 77708-1228
Phone (409) 434-4436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1352678400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352678400000",
    "number": "1861736035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6487 TAHOE DR",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777081228",
            "telephone_number": "409-434-4436",
            "fax_number": "888-503-0567"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3115 WASHINGTON BLVD",
            "city": "BEAUMONT",
            "state": "TX",
            "postal_code": "777051359",
            "telephone_number": "409-842-5005",
            "fax_number": "888-503-0567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "TERRY",
        "middle_name": "LENNELL",
        "name_prefix": "Mr.",
        "credential": "HUB CERTIFIED",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-12",
        "last_updated": "2012-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": "TX",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaumont, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.