BRANDON KEITH VAN DEMAN (NPI# 1629693841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1629693841 |
Entity Type | Individual |
Full Name | BRANDON KEITH VAN DEMAN |
Practice Address |
5100 Sweetbriar Ln Apt 507 Tyler TX 75703-3857 |
Practice Telephone | 9034844343 |
Mailing Telephone | 9034844343 |
Enumeration Date | 2020-06-12 |
Last Update Date | 2020-06-12 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LS0200X |
Nurse Practitioner Specialization: School |
878314 | TX | Physician Assistants & Advanced Practice Nursing Providers |
Street Address |
5100 SWEETBRIAR LN APT 507 |
City | TYLER |
State | TX |
Zip Code | 75703-3857 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1174155477 | Choice Supportive Care Team Inc. | Family Medicine | 4293 Kinsey Drive, Tyler, TX 75703 | 2020-02-05 |
1770052532 | Refinery Chiropractic LLC | Chiropractor | 16637 Old Jacksonville Hwy, Suite D, Tyler, TX 75703 | 2018-11-21 |
1215419353 | Deidre Lynn Fergason | Occupational Therapy Assistant | 3505 Old Jacksonville Hwy, Tyler, TX 75703 | 2018-09-05 |
1710473681 | Justin Taylor Ross | Dentist | 8938 S Broadway Ave Ste 380, Tyler, TX 75703 | 2018-07-03 |
1457843450 | Adam Tyler Barnes, Dds of Texas II, Pllc | Dentist | 8938 South Broadway, Ste 480, Tyler, TX 75703 | 2018-06-05 |
1083106462 | Integrity Health | Internal Medicine | 5605 Old Bullard Rd Ste B, Tyler, TX 75703 | 2018-06-01 |
1427572544 | Cody Wayne Graham | Pharmacist | 5415 S. Broadway Ave., Tyler, TX 75703 | 2017-07-31 |
1750805941 | Roger Bryan Chapman | Nurse Practitioner | 6115 New Copeland Rd, Tyler, TX 75703 | 2017-07-28 |
1427570084 | Darah Lynne Dahlem | Speech-Language Pathologist | 401 E. Front Street Ste 123, Tyler, TX 75703 | 2017-07-14 |
1194267468 | Herman Lester Hampton Jr. | Surgery | 5803 Regents Row, Tyler, TX 75703 | 2016-11-17 |
Find all providers in zip 75703 |
Taxonomy Code | 363LS0200X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | School |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1104343276 | University of Texas Health Science Center At San Antonio | Nurse Practitioner | 7703 Floyd Curl Dr Rm 1.422, San Antonio, TX 78229-3901 | 2017-08-29 |
1285797076 | Toni L. Deleon | Nurse Practitioner | 5201 Harry Hines Blvd, Medical Staff Services, Dallas, TX 75235-7708 | 2006-12-19 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.