Provider Demographics
NPI:1235191180
Name:BRANNON, TIMOTHY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:SCOTT
Last Name:BRANNON
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:5323 HARRY HINES BLVD
Mailing Address - Street 2:U.T. SOUTHWESTERN MEDICAL CENTER - PEDIATRICS
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75390-7201
Mailing Address - Country:US
Mailing Address - Phone:214-648-3727
Mailing Address - Fax:214-648-2481
Practice Address - Street 1:5323 HARRY HINES BLVD
Practice Address - Street 2:U.T. SOUTHWESTERN MEDICAL CENTER - PEDIATRICS
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75390-7201
Practice Address - Country:US
Practice Address - Phone:214-648-3727
Practice Address - Fax:214-648-2481
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH60692080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH6069OtherTEXAS MEDICAL LICENSE NUM