Provider Demographics
NPI:1336709625
Name:GORMAN, BRENDAN THOMAS (DO)
Entity Type:Individual
Prefix:DR
First Name:BRENDAN
Middle Name:THOMAS
Last Name:GORMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:301 UNIVERSITY BLVD
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0540
Mailing Address - Country:US
Mailing Address - Phone:409-772-2091
Mailing Address - Fax:409-772-5144
Practice Address - Street 1:301 UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-0540
Practice Address - Country:US
Practice Address - Phone:409-772-2091
Practice Address - Fax:409-772-5144
Is Sole Proprietor?:No
Enumeration Date:2019-06-18
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP10068816208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology