Provider Demographics
NPI:1265798672
Name:BROWN LUPTON HEALTH CENTER
Entity type:Organization
Organization Name:BROWN LUPTON HEALTH CENTER
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:TORGERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:817-257-5265
Mailing Address - Street 1:PO BOX 297400
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76129-0001
Mailing Address - Country:US
Mailing Address - Phone:817-257-7940
Mailing Address - Fax:817-257-7279
Practice Address - Street 1:2825 STADIUM DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-1377
Practice Address - Country:US
Practice Address - Phone:817-257-7940
Practice Address - Fax:817-257-7279
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TEXAS CHRISTIAN UNIVERSITY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS1000XAmbulatory Health Care FacilitiesClinic/CenterStudent Health