Healthcare Provider Details

I. General information

NPI: 1003426834
Provider Name (Legal Business Name): BRANDT DAVID YEAMANS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 03/10/2023
Certification Date: 03/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4301 GARTH RD STE 200
BAYTOWN TX
77521-3157
US

IV. Provider business mailing address

4301 GARTH RD STE 200
BAYTOWN TX
77521-3157
US

V. Phone/Fax

Practice location:
  • Phone: 281-422-7970
  • Fax:
Mailing address:
  • Phone: 281-422-7970
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LC0200X
TaxonomyCritical Care Medicine Nurse Practitioner
License NumberAP143829
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP143829
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: