Provider Demographics
NPI:1538394317
Name:ZINN, BRANDON KEITH (DO)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:KEITH
Last Name:ZINN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4515 SETON CENTER PKWY
Mailing Address - Street 2:SUITE 215
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-5290
Mailing Address - Country:US
Mailing Address - Phone:512-231-5506
Mailing Address - Fax:512-406-7303
Practice Address - Street 1:801 E WHITESTONE BLVD
Practice Address - Street 2:BLDG B
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-5028
Practice Address - Country:US
Practice Address - Phone:512-259-3467
Practice Address - Fax:512-406-7303
Is Sole Proprietor?:No
Enumeration Date:2009-05-21
Last Update Date:2017-06-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN2351207Q00000X, 207P00000X, 207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX219741007Medicaid
TX219741006Medicaid