BRANDON KEITH VAN DEMAN


Address: 5100 Sweetbriar Ln Apt 507, Tyler, TX 75703-3857
Phone: 9034844343

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LS0200X Nurse Practitioner
Specialization: School
878314 TX Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 5100 SWEETBRIAR LN APT 507
City TYLER
State TX
Zip Code 75703-3857

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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
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Taxonomy Information

Taxonomy Code 363LS0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization School

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and state

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

Competitor

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City TYLER
Zip Code 75703

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Dataset Information

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.

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