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General NPI Number Information
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NPI Number | 1154186187
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Entity Type | Individual
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Provider Name | ALLISON BRANDON PA
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Gender | Female
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Dates
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Enumeration Date | 02/19/2024
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Last Update Date | 02/19/2024
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Provider Practice Location Address
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Address Line | 901 W BEN WHITE BLVD FL 1
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City | AUSTIN
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State | TX
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Zip | 78704-6903
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Country | US
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Telephone | 151-244-7221
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Fax |
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Provider Business Mailing Address
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Address Line | 2803 CIMARRON CT
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City | COLLEGE STATION
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State | TX
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Zip | 77845-7721
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Country | US
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Telephone | 979-777-7319
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17594
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License Number State | TX
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