Healthcare Provider Details
I. General information
NPI: 1942837042
Provider Name (Legal Business Name): BRANDON JAMES PIRES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 03/26/2020
Last Update Date: 02/01/2024
Certification Date: 02/01/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1950 MOUNTAIN VIEW AVE
LONGMONT CO
80501-3129
US
IV. Provider business mailing address
PO BOX 800022
KANSAS CITY MO
64180-0022
US
V. Phone/Fax
- Phone: 303-485-3066
- Fax: 303-485-3060
- Phone: 800-953-0104
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | T8017 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207QA0505X |
| Taxonomy | Adult Medicine Physician |
| License Number | DR.0071152 |
| License Number State | CO |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208M00000X |
| Taxonomy | Hospitalist Physician |
| License Number | DR.0071152 |
| License Number State | CO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: