Provider Demographics
NPI:1477237477
Name:BUNDAGE, BRIANA NICOL
Entity Type:Individual
Prefix:MRS
First Name:BRIANA
Middle Name:NICOL
Last Name:BUNDAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:BRIANA
Other - Middle Name:NICOL
Other - Last Name:BUNDAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15807 GRAHAM SPRING LN.
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77044
Mailing Address - Country:US
Mailing Address - Phone:346-520-2748
Mailing Address - Fax:
Practice Address - Street 1:15807 GRAHAM SPRING LN.
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77044
Practice Address - Country:US
Practice Address - Phone:346-520-2748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-12
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty