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General NPI Number Information
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NPI Number | 1598430548
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Entity Type | Individual
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Provider Name | JUAN ANDRES BRUBAKER PA-C
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Gender | Male
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Dates
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Enumeration Date | 08/11/2021
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Last Update Date | 08/13/2025
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Provider Practice Location Address
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Address Line | 2730 SW WILSHIRE BLVD
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City | BURLESON
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State | TX
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Zip | 76028-8338
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Country | US
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Telephone | 817-916-5180
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Fax | 817-916-5199
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Provider Business Mailing Address
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Address Line | 500 UNIVERSITY DRIVE
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City | HERSHEY
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State | PA
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Zip | 17033-2360
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Country | US
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Telephone | 800-243-1455
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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 |
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License Number State |
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