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NPI Code Detail

MEDICARE: BRANDON HOUSTON

MEDICARE: BRANDON HOUSTON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1367H00000XAnesthesiologist AssistantGA

General Provider Information

NPI Number : 1457214835
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON HOUSTON
Provider Business Mailing Address
First Line : 1055 WILLOW SPRINGS DR
Second Line :
City : NORTH AUGUSTA
State : SC
Zip : 29841-4693
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1364 CLIFTON RD NE
Second Line :
City : ATLANTA
State : GA
Zip : 30322-1059
Country : US
Telephone Number : 404-712-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ BRANDON HOUSTON ” Practice Location

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