Provider Demographics
NPI:1578839809
Name:BRANDT, RICHARD LANE (ATP)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LANE
Last Name:BRANDT
Suffix:
Gender:M
Credentials:ATP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24326 ROCKIN SEVEN DR.
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447
Mailing Address - Country:US
Mailing Address - Phone:832-767-9296
Mailing Address - Fax:713-664-7222
Practice Address - Street 1:4950 TERMINAL ST.
Practice Address - Street 2:SUITE #200
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401
Practice Address - Country:US
Practice Address - Phone:713-344-0901
Practice Address - Fax:713-664-7222
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other