Provider Demographics
NPI:1104038512
Name:BRANCH, R. E (M D)
Entity Type:Individual
Prefix:DR
First Name:R.
Middle Name:E
Last Name:BRANCH
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15150 PRESTON RD STE 300
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75248-4871
Mailing Address - Country:US
Mailing Address - Phone:972-934-3231
Mailing Address - Fax:972-233-7762
Practice Address - Street 1:15150 PRESTON RD STE 300
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248-4871
Practice Address - Country:US
Practice Address - Phone:972-934-3231
Practice Address - Fax:972-233-7762
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD6378208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine