Provider Demographics
NPI:1023200540
Name:BRANDI, LUIS H (MD)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:H
Last Name:BRANDI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3601 4TH ST STOP 8115
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-8115
Mailing Address - Country:US
Mailing Address - Phone:806-743-2155
Mailing Address - Fax:806-743-2117
Practice Address - Street 1:3601 4TH ST STOP 8115
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-1143
Practice Address - Country:US
Practice Address - Phone:806-743-2155
Practice Address - Fax:806-743-2117
Is Sole Proprietor?:No
Enumeration Date:2007-08-17
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA144195207ZP0101X
FLME133558207ZP0102X
TXR6979207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0101XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology