Provider Demographics
NPI:1891115275
Name:ADDISON, BRANDI (DO)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:ADDISON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:DEBOSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7121 S PADRE ISLAND DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78412-4940
Mailing Address - Country:US
Mailing Address - Phone:361-696-6200
Mailing Address - Fax:
Practice Address - Street 1:7121 S PADRE ISLAND DR STE 300
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78412-4940
Practice Address - Country:US
Practice Address - Phone:361-696-6200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-23
Last Update Date:2018-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8405207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism