Provider Demographics
NPI:1033220686
Name:BRANDON, HEATHER BETH (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:BETH
Last Name:BRANDON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:HEATHER
Other - Middle Name:BETH
Other - Last Name:HUGHES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11212 STATE HIGHWAY 151
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-4498
Mailing Address - Country:US
Mailing Address - Phone:210-733-4362
Mailing Address - Fax:210-521-1517
Practice Address - Street 1:11212 STATE HIGHWAY 151
Practice Address - Street 2:SUITE 300
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-4498
Practice Address - Country:US
Practice Address - Phone:210-733-4362
Practice Address - Fax:210-521-1517
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3927208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics