Provider Demographics
NPI:1386232999
Name:BRELSFORD, BRANDEN WIRAK (DO)
Entity Type:Individual
Prefix:
First Name:BRANDEN
Middle Name:WIRAK
Last Name:BRELSFORD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:DEPT OF IM/NEUROLOGY 2401 S 31ST ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76508-0001
Mailing Address - Country:US
Mailing Address - Phone:254-724-4472
Mailing Address - Fax:254-724-5741
Practice Address - Street 1:DEPT OF IM/NEUROLOGY 2401 S 31ST ST
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76508-0001
Practice Address - Country:US
Practice Address - Phone:254-724-4472
Practice Address - Fax:254-724-5741
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2023-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program