Healthcare Provider Details

I. General information

NPI: 1457797375
Provider Name (Legal Business Name): BRANDON WILLIAMSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2013
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 E 29TH ST STE 200
BRYAN TX
77802-2623
US

IV. Provider business mailing address

2900 E 29TH ST STE 100
BRYAN TX
77802-2623
US

V. Phone/Fax

Practice location:
  • Phone: 979-776-8440
  • Fax: 877-601-5854
Mailing address:
  • Phone: 979-776-8440
  • Fax: 877-601-5854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberQ1772
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberQ1772
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: