Provider Demographics
NPI:1619096690
Name:BRANNIGAN, YVONNE M (PT, LMT)
Entity Type:Individual
Prefix:MS
First Name:YVONNE
Middle Name:M
Last Name:BRANNIGAN
Suffix:
Gender:F
Credentials:PT, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 372
Mailing Address - Street 2:
Mailing Address - City:ARGYLE
Mailing Address - State:TX
Mailing Address - Zip Code:76226-0372
Mailing Address - Country:US
Mailing Address - Phone:940-591-7071
Mailing Address - Fax:
Practice Address - Street 1:2126 HAMILTON DR STE 230
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-2129
Practice Address - Country:US
Practice Address - Phone:940-591-7071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-28
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1078277225100000X
TXMT045094225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX818T80OtherBCBS
TX818T80OtherBCBS