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General NPI Number Information
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NPI Number | 1669245692
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Entity Type | Individual
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Provider Name | BRANDON MICHAEL MINTON CRNA
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Gender | Male
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Dates
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Enumeration Date | 11/01/2023
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 801 W INTERSTATE 20
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City | ARLINGTON
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State | TX
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Zip | 76017-5851
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Country | US
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Telephone | 817-886-4456
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Fax |
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Provider Business Mailing Address
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Address Line | 2126 E DRY CREEK RD
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City | POOLVILLE
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State | TX
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Zip | 76487-5719
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Country | US
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Telephone | 806-676-6777
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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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 11042024
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 1140870
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | D185013
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License Number State | IA
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