Provider Demographics
NPI:1225444037
Name:BRANDON, PATRICK MARK (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:MARK
Last Name:BRANDON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5345 N IH 35
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78723-2428
Mailing Address - Country:US
Mailing Address - Phone:512-452-9452
Mailing Address - Fax:
Practice Address - Street 1:5345 N IH 35
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-2428
Practice Address - Country:US
Practice Address - Phone:512-452-9452
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-02
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS020567183500000X
FLPS53042183500000X
TX60370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist