Provider Demographics
NPI:1720484389
Name:MCBRIDE, BRANDI (PT, DPT)
Entity Type:Individual
Prefix:
First Name:BRANDI
Middle Name:
Last Name:MCBRIDE
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:BRANDI
Other - Middle Name:
Other - Last Name:BATES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14862 COUNTY ROAD 489
Mailing Address - Street 2:
Mailing Address - City:NEVADA
Mailing Address - State:TX
Mailing Address - Zip Code:75173-6044
Mailing Address - Country:US
Mailing Address - Phone:214-679-4377
Mailing Address - Fax:866-476-1114
Practice Address - Street 1:14862 COUNTY ROAD 489
Practice Address - Street 2:
Practice Address - City:NEVADA
Practice Address - State:TX
Practice Address - Zip Code:75173-6044
Practice Address - Country:US
Practice Address - Phone:214-679-4377
Practice Address - Fax:866-476-1114
Is Sole Proprietor?:No
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1207667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist