Provider Demographics
NPI:1508389206
Name:BRANDT, CHARLES PHILIP II (PHD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:PHILIP
Last Name:BRANDT
Suffix:II
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 E 19TH ST
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-4488
Mailing Address - Country:US
Mailing Address - Phone:832-900-1276
Mailing Address - Fax:
Practice Address - Street 1:708 E 19TH ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77008-4488
Practice Address - Country:US
Practice Address - Phone:832-900-1276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37048103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical