Provider Demographics
NPI:1265947261
Name:ROATCH-CARDENAS, BRENDON GAEL (NREMT)
Entity type:Individual
Prefix:MR
First Name:BRENDON
Middle Name:GAEL
Last Name:ROATCH-CARDENAS
Suffix:
Gender:M
Credentials:NREMT
Other - Prefix:MR
Other - First Name:BRENDON
Other - Middle Name:GAEL
Other - Last Name:O'HARA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NREMT
Mailing Address - Street 1:POST OFFICE BOX 341
Mailing Address - Street 2:
Mailing Address - City:FULSHEAR
Mailing Address - State:TX
Mailing Address - Zip Code:77441
Mailing Address - Country:US
Mailing Address - Phone:713-376-6092
Mailing Address - Fax:
Practice Address - Street 1:POST OFFICE BOX 341
Practice Address - Street 2:
Practice Address - City:FULSHEAR
Practice Address - State:TX
Practice Address - Zip Code:77441
Practice Address - Country:US
Practice Address - Phone:713-376-6092
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-13
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX766689146N00000X
146L00000X, 273R00000X, 103TM1800X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & AdolescentGroup - Multi-Specialty
Yes146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty
No146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, ParamedicGroup - Multi-Specialty
No273R00000XHospital UnitsPsychiatric UnitGroup - Multi-Specialty
No103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty