Provider Demographics
NPI:1023571783
Name:CONTRERAS, BRIAN XAVIER (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:XAVIER
Last Name:CONTRERAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 NW 41ST AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-1835
Mailing Address - Country:US
Mailing Address - Phone:352-872-2214
Mailing Address - Fax:
Practice Address - Street 1:605 E SAN ANTONIO ST STE 330E
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-6028
Practice Address - Country:US
Practice Address - Phone:361-576-9386
Practice Address - Fax:361-576-9502
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-10
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10066657207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine