Provider Demographics
NPI:1205505708
Name:BRANAMAN, MAIRYN (DPT)
Entity type:Individual
Prefix:
First Name:MAIRYN
Middle Name:
Last Name:BRANAMAN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 AMESBURY DR APT 1133
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75206-0006
Mailing Address - Country:US
Mailing Address - Phone:240-298-9066
Mailing Address - Fax:
Practice Address - Street 1:7511 MAIN ST STE 170
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-5314
Practice Address - Country:US
Practice Address - Phone:240-298-9066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-08
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1368478225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist