Provider Demographics
NPI:1548634389
Name:BROWN, JOSHUA (FNP)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:BROWN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8901 TEHAMA RIDGE PKWY
Mailing Address - Street 2:STE 217 #317
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177
Mailing Address - Country:US
Mailing Address - Phone:214-966-3089
Mailing Address - Fax:
Practice Address - Street 1:2700 TIBBETS DR STE 104
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-6900
Practice Address - Country:US
Practice Address - Phone:214-966-3089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-11-17
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129652363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily