MEDICARE: BRANDAN GERRY

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
1	2279E1000X	Educational Registered Respiratory Therapist	77061	TX

General Provider Information

NPI Number	:	1750766135
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRANDAN GERRY

Provider Business Mailing Address
First Line	:	6418 ECKHERT RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78240-2896
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4803 NW LOOP 410 STE 200
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78229-4208
Country	:	US
Telephone Number	:	210-598-8090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/27/2015
Last Update Date	:	07/27/2015

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Directions to “ BRANDAN GERRY ” Practice Location

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