Provider Demographics
NPI:1881616860
Name:BONDS, BRANDON MARSHALL (DC)
Entity type:Individual
Prefix:DR
First Name:BRANDON
Middle Name:MARSHALL
Last Name:BONDS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17330 PRESTON RD
Mailing Address - Street 2:#140-A
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252
Mailing Address - Country:US
Mailing Address - Phone:972-248-4994
Mailing Address - Fax:972-248-4973
Practice Address - Street 1:17101 PRESTON RD
Practice Address - Street 2:#190
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75248
Practice Address - Country:US
Practice Address - Phone:972-248-4994
Practice Address - Fax:972-248-4973
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8232111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
609282Medicare ID - Type Unspecified
U77539Medicare UPIN