Provider Demographics
NPI:1477808020
Name:HARTMAN, LEE BRANDON (DC)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:BRANDON
Last Name:HARTMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 HARRIS PKWY
Mailing Address - Street 2:
Mailing Address - City:FT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76132-4103
Mailing Address - Country:US
Mailing Address - Phone:817-370-6350
Mailing Address - Fax:
Practice Address - Street 1:6001 HARRIS PKWY
Practice Address - Street 2:
Practice Address - City:FT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76132-4103
Practice Address - Country:US
Practice Address - Phone:817-370-6350
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-19
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12073111NR0400X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NR0400XChiropractic ProvidersChiropractorRehabilitation