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General NPI Number Information
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NPI Number | 1467179200
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Entity Type | Individual
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Provider Name | JENNIFER LYNN BRANDES MPT
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Gender | Female
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 10/24/2022
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Provider Practice Location Address
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Address Line | 235 W PALM ST STE 111
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City | BELLVILLE
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State | TX
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Zip | 77418-1300
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Country | US
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Telephone | 979-413-7330
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Fax | 979-413-7339
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Provider Business Mailing Address
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Address Line | 8695 HILLBOLDT RD
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City | CAT SPRING
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State | TX
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Zip | 78933-5046
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Country | US
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Telephone | 713-202-3367
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1129633
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License Number State | TX
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