Provider Demographics
NPI:1669699740
Name:BRANDON, THOMAS R (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:R
Last Name:BRANDON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3730 KIRBY DR
Mailing Address - Street 2:SUITE 1200
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77098-3905
Mailing Address - Country:US
Mailing Address - Phone:713-524-8307
Mailing Address - Fax:713-831-6884
Practice Address - Street 1:3730 KIRBY DR
Practice Address - Street 2:SUITE 1200
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77098-3905
Practice Address - Country:US
Practice Address - Phone:713-524-8307
Practice Address - Fax:713-831-6884
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXD26482084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB21463Medicare UPIN
TX00M093Medicare ID - Type Unspecified