Healthcare Provider Details

I. General information

NPI: 1053260943
Provider Name (Legal Business Name): BRIANNA MINARD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1977 BUTLER BLVD STE E5.200
HOUSTON TX
77030-4101
US

IV. Provider business mailing address

1977 BUTLER BLVD STE E5.200
HOUSTON TX
77030-4101
US

V. Phone/Fax

Practice location:
  • Phone: 713-798-5900
  • Fax: 713-798-5841
Mailing address:
  • Phone: 713-798-5900
  • Fax: 713-798-5841

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20316
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: