Provider Demographics
NPI:1336482751
Name:HOOPER, BRANDON JAMES (DDS)
Entity Type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:JAMES
Last Name:HOOPER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:BRANDON
Other - Middle Name:JAMES
Other - Last Name:HOOPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1330 OLD SPANISH TRL
Mailing Address - Street 2:APT. 1308
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-1800
Mailing Address - Country:US
Mailing Address - Phone:607-215-5213
Mailing Address - Fax:
Practice Address - Street 1:2002 HOLCOMBE BLVD
Practice Address - Street 2:DENTAL SERVICE (160)
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-4211
Practice Address - Country:US
Practice Address - Phone:607-215-5213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-04-03
Last Update Date:2013-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29471122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist