Healthcare Provider Details

I. General information

NPI: 1821887084
Provider Name (Legal Business Name): SHAYLEA MAKALL BRANDON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7616 BRANFORD PL STE 140
SUGAR LAND TX
77479-3794
US

IV. Provider business mailing address

PO BOX 654439
DALLAS TX
75265-4439
US

V. Phone/Fax

Practice location:
  • Phone: 281-888-8999
  • Fax: 281-305-4054
Mailing address:
  • Phone: 281-888-8999
  • Fax: 281-305-4054

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1193361
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: