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NPI Code Detail

MEDICARE: REAGAN BRANDT

MEDICARE: REAGAN BRANDT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1247200000XOther Technician

General Provider Information

NPI Number : 1063936896
Entity Type Code : Individual
Provider Name (Legal Business Name) : REAGAN BRANDT
Provider Business Mailing Address
First Line : 21600 OXNARD ST STE 1800
Second Line :
City : WOODLAND HILLS
State : CA
Zip : 91367-7807
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3845 CYPRESS CREEK PKWY STE 215
Second Line :
City : HOUSTON
State : TX
Zip : 77068-3575
Country : US
Telephone Number : 281-713-9985
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2017
Last Update Date : 08/02/2017

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Directions to “ REAGAN BRANDT ” Practice Location

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