Healthcare Provider Details

I. General information

NPI: 1699149302
Provider Name (Legal Business Name): ANTHONY JULIO BRANKER D.C., M.S., DACBSP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: TONY JULIO BRANKER D.C.

II. Dates (important events)

Enumeration Date: 11/18/2015
Last Update Date: 04/08/2022
Certification Date: 02/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6363 RICHMOND AVE STE 260
HOUSTON TX
77057-5950
US

IV. Provider business mailing address

6122 GLADEWELL DR
HOUSTON TX
77072-1502
US

V. Phone/Fax

Practice location:
  • Phone: 832-580-9743
  • Fax: 832-201-0797
Mailing address:
  • Phone: 832-580-9743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number13068
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License NumberAT3682
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number13068
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: