Healthcare Provider Details

I. General information

NPI: 1497659668
Provider Name (Legal Business Name): BTROYGARLAND PROFESSIONAL LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

660 DEXTER ST
DENVER CO
80220-5038
US

IV. Provider business mailing address

660 DEXTER ST
DENVER CO
80220-5038
US

V. Phone/Fax

Practice location:
  • Phone: 619-309-7053
  • Fax:
Mailing address:
  • Phone: 619-309-7053
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: BRANDON TYLER ROY-GARLAND
Title or Position: OWNER
Credential: MD
Phone: 307-690-9860