Provider Demographics
NPI:1669894341
Name:LIN, BRANDON
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:
Last Name:LIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 W RANDOL MILL RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-6509
Mailing Address - Country:US
Mailing Address - Phone:281-748-6304
Mailing Address - Fax:
Practice Address - Street 1:1119 W RANDOL MILL RD
Practice Address - Street 2:SUITE 106
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-6509
Practice Address - Country:US
Practice Address - Phone:281-748-6304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2014-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RM2200XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyMedical Laboratory