Provider Demographics
NPI:1932677127
Name:FORD, BRANDI DAWN
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:DAWN
Last Name:FORD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 VANDENBURG DR APT A
Mailing Address - Street 2:
Mailing Address - City:DENISON
Mailing Address - State:TX
Mailing Address - Zip Code:75020-6537
Mailing Address - Country:US
Mailing Address - Phone:903-819-1371
Mailing Address - Fax:
Practice Address - Street 1:133 VANDENBURG DR APT A
Practice Address - Street 2:
Practice Address - City:DENISON
Practice Address - State:TX
Practice Address - Zip Code:75020-6537
Practice Address - Country:US
Practice Address - Phone:903-819-1371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2018-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant