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General NPI Number Information
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NPI Number | 1235129495
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Entity Type | Individual
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Provider Name | BRANDON THOMPSON LSA
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Gender | Male
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 07/07/2021
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Provider Practice Location Address
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Address Line | 7401 S. MAIN
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 713-799-2300
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Fax | 713-383-5201
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Provider Business Mailing Address
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Address Line | 7401 MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77030-4509
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Country | US
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Telephone | 713-799-2300
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Fax | 713-794-3380
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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 | 246ZS0410X
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Taxonomy Name | Surgical Technologist
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License Number | 87330
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 246ZC0007X
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Taxonomy Name | Surgical Assistant
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License Number | SA00850
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License Number State | TX
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