Provider Demographics
NPI:1154085819
Name:LUNSFORD, BRANDON (FNP-BC)
Entity Type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:LUNSFORD
Suffix:
Gender:M
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5935 SMOKY QUARTZ
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78222-4133
Mailing Address - Country:US
Mailing Address - Phone:479-637-6539
Mailing Address - Fax:
Practice Address - Street 1:1730 SW MILITARY DR STE 103
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-1400
Practice Address - Country:US
Practice Address - Phone:214-341-9614
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-28
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1057350363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily