Provider Demographics
NPI:1609537943
Name:BUTLER, BRANDY (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:BRANDY
Middle Name:
Last Name:BUTLER
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3015 WESLAYAN ST APT 6046
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-5790
Mailing Address - Country:US
Mailing Address - Phone:702-224-4435
Mailing Address - Fax:
Practice Address - Street 1:3015 WESLAYAN ST APT 6046
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-5790
Practice Address - Country:US
Practice Address - Phone:702-224-4435
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-09
Last Update Date:2022-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date: