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NPI Code Detail

MEDICARE: BRANDON CONTRERAS

MEDICARE:   BRANDON  CONTRERAS
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
1171W00000XContractor

General Provider Information

NPI Number : 1962801662
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRANDON CONTRERAS
Provider Business Mailing Address
First Line : PO BOX 140851
Second Line :
City : DALLAS
State : TX
Zip : 75214-0851
Country : US
Telephone Number : 817-726-3118
Fax Number :
Provider Business Practice Location Address
First Line : 2122 KIDWELL ST
Second Line :
City : DALLAS
State : TX
Zip : 75214-3913
Country : US
Telephone Number : 817-726-3118
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2014
Last Update Date : 09/19/2014

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Directions to “ BRANDON CONTRERAS ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.